EMILY SULLIVAN , NPI 1487021614 — AMHERST (NY)

NPI 1487021614

4+ Years Experience Individual

EMILY SULLIVAN

08/24/2015
PROVIDER ENUMERATION DATE
08/24/2015
LAST UPDATE DATE
1487021614
NPI NUMBER

About EMILY SULLIVAN

Sole proprietor? No, Entity Type 1 Provider (Individual) is not a Sole Proprietor.

EMILY SULLIVAN is a provider established in AMHERST, NY. The NPI number of EMILY SULLIVAN is 1487021614 and was assigned on 08/24/2015. The practitioners primary taxonomy code is: 390200000X with license number: 1261831 NY .

Mailing address

  • City: KENMORE
  • State: NY
  • Postal code: 142171242
  • Phone: 5853136774
  • Address: 146 HAMPTON PKWY

Primary Practice Address

  • Region : AMHERST, NY
  • NPI : 1487021614
  • Phone : 7168192408
  • Postalcode : 142265122
  • Address : 4242 RIDGE LEA RD STE 2

Provider taxonomy - Student in an Organized Health Care Education/Training Program

  • Taxonomy code: 390200000X
  • License number: 1261831
  • License state: NY

The taxonomy is the primary taxonomy (there can be only one per NPI record).

Taxonomy description: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

Contacts:

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  • EMILY SULLIVAN
  • Address : 4242 RIDGE LEA RD STE 2
  • Region : AMHERST, NY
  • NPI : 1487021614
  • Phone : 7168192408
  • Postalcode : 142265122

Reference NPI Information. Full replica of the CMS (NPPES) NPI record

Field Name Value
Provider First Line Business Practice Location Address4242 RIDGE LEA RD STE 2
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City NameAMHERST
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State NameNY
The State or Province name in the location address of the provider being identified.
Provider Business Practice Location Address Postal Code142265122
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Telephone Number7168192408
The telephone number associated with the location address of the provider being identified.
NPI1487021614
10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider.
Healthcare Provider Taxonomy 1390200000X
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
Provider Enumeration Date08/24/2015
The date the provider was assigned a unique identifier (assigned an NPI).
Last Updated08/24/2015
The date that a record was last updated or changed.
Entity TypeIndividual
Code describing the type of health care provider that is being assigned an NPI. Codes are:
  • 1 = (Person): individual human being who furnishes health care;
  • 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Provider Organization Name (Legal Business Name)EMILY SULLIVAN
Provide organization name (legal business name used to file tax returns with the IRS). The Organization Name field allows the following special characters: ampersand, apostrophe, "at" sign, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters.
Provider First Line Business Mailing Address146 HAMPTON PKWY
The first line mailing address of the provider being identified. This data element may contain the same information as "Provider first line location address".
Provider Business Mailing Address City NameKENMORE
The City name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address City name".
Provider Business Mailing Address State NameNY
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address State name".
Provider Business Mailing Address Postal Code142171242
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as "Provider location address postal code".
Provider Business Mailing Address Telephone Number5853136774
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as "Provider location address telephone number".
Healthcare Provider Taxonomy Code #1390200000X
The Health Care Provider Taxonomy code is a unique alphanumeric code, ten characters in length. The code set is structured into three distinct "Levels" including Provider Type, Classification, and Area of Specialization.
Healthcare Provider Taxonomy 1Student in an Organized Health Care Education/Training Program
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
Provider License Number 11261831
Certain taxonomy selections will require you to enter your license number and the state where the license was issued. Select Foreign Country in the state drop down box if the license was issued outside of United States. The License Number field allows the following special characters: ampersand, apostrophe, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters. DO NOT report the Social Security Number (SSN), IRS Individual Taxpayer Identification Number (ITIN) in this section.
Provider License Number State Code 1NY
Healthcare Provider Primary Taxonomy Switch 1Y
Primary Taxonomy:
  • X - The primary taxonomy switch is Not Answered;
  • Y - The taxonomy is the primary taxonomy (there can be only one per NPI record);
  • N - The taxonomy is not the primary taxonomy.
Provider Gender CodeF
  • M - male
  • F - female
Is sole proprietorN
  • X - Not Answered
  • Y - Yes, Entity Type 1 Provider (Individual) is a Sole Proprietor
  • N - No, Entity Type 1 Provider (Individual) is not a Sole Proprietor
X

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