Theresa Paulette Sullivan, AUD

Primary specialty

AudiologistTaxonomy code 231H00000X

License

001487 Issued in NY

Practice address

250 Tuytenbridge Rd
Lake Katrine, NY 12449-5429

Phone

(845) 336-7235

Fax

(845) 336-4726

NPI assigned

Apr 24, 2007

Last updated

Jan 25, 2011By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Capital Region Otolaryngology Head & Neck Group

  • Specialist
  • Ghent, NY
  • NPI 1033484142
  NPD (past)
• Capital Region Otolaryngology Head & Neck Group

  • Specialist
  • Clifton Park, NY
  • NPI 1497020507
  NPD (past)
• Capital Region Otolaryngology Head & Neck Group

  • Specialist
  • Troy, NY
  • NPI 1548526726
  NPD (past)
• United Cerebral Palsy of Ulster County Inc.

  • Developmental Disabilities Clinic/Center
  • Lake Katrine, NY
  • NPI 1982763678
  NPD (past)

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

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1295913600000",
    "number": "1205055076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "513 PINE RD",
            "city": "COPAKE",
            "state": "NY",
            "postal_code": "125161109",
            "telephone_number": "518-329-5761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 TUYTENBRIDGE RD",
            "city": "LAKE KATRINE",
            "state": "NY",
            "postal_code": "124495429",
            "telephone_number": "845-336-7235",
            "fax_number": "845-336-4726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "THERESA",
        "middle_name": "PAULETTE",
        "name_prefix": "Dr.",
        "credential": "AUD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-24",
        "last_updated": "2011-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "NY",
            "license": "001487",
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "001886",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00473001",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Adam D Soyer, DO
• Valerie M Sprenz, M.D.
• Shannon Maureen Stanton
• Elizabeth Victoria Stone, LPN
• Dennis Styles, PA
• Kinneret Sussman
• Tenbc Inc (Ten Broeck Commons)
• The Institute for Family Health
• Melissa M Thomson, R.N.
• Lauryn Rae Tortora

• Audiologist in Lake Katrine, NY
• Providers in Lake Katrine, NY by specialty
• Audiologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2011; 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.