Maureen Sullivan, P.A.-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

25MP000245 Issued in NJ

Practice address

17 W Red Bank Ave
Suite 207
Woodbury, NJ 08096-1630

Phone

(856) 845-0664

Fax

(856) 845-7602

NPI assigned

Jul 11, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Atlantic Professional Services of New Jersey, P.a.

  • Physician Assistant
  • Stratford, NJ
  • NPI 1932145182
  NPD (past)
• Inspira Health Network Medical Group, P.C.

  dba Inspira Medical Group

  • Multi-Specialty Clinic/Center
  • Glassboro, NJ
  • NPI 1922177856
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416441600000",
    "number": "1033144019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 CHATHAM DR",
            "city": "VOORHEES",
            "state": "NJ",
            "postal_code": "080432953"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 W RED BANK AVE",
            "address_2": "SUITE 207",
            "city": "WOODBURY",
            "state": "NJ",
            "postal_code": "080961630",
            "telephone_number": "856-845-0664",
            "fax_number": "856-845-7602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "MAUREEN",
        "credential": "P.A.-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-11",
        "last_updated": "2014-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP000245",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "MA003234L",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "25MP000245",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amanda Lynn Stein, LCSW
• Jay A. Stiefel, D.O.
• Kyle Stinsman, BCABA
• Tonette Stubbs, LSW
• Suburban Health Clinic of Woodbury
• Sunrise Hovcare L.P. (Sunrise at Woodbury Lake)
• Surgical & Critical Care Associates
• SWB Medical Group LLC
• Yuzana Swe, MD
• Brielle Sykes

• Physician Assistant in Woodbury, NJ
• Providers in Woodbury, NJ by specialty
• Physician Assistant in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.