Jaysen Sullivan

Primary specialty

SpecialistTaxonomy code 174400000X

License

$$$$$$$$$ Issued in NY

Practice address

683 Henderson Ave
Staten Island, NY 10310-1575

Phone

(718) 682-1831

NPI assigned

Nov 29, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1669680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669680000000",
    "number": "1700596897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 NEW ST",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103021540",
            "telephone_number": "917-202-6143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "683 HENDERSON AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103101575",
            "telephone_number": "718-682-1831"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "JAYSEN",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-11-29",
        "last_updated": "2022-11-29",
        "certification_date": "2022-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "$$$$$$$$$",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ciara Sullivan, LMHC
• Deborah Ann Sullivan, M.S.
• Deborah Christine Sullivan
• Erin Sullivan
• Felicia Ronsay Sullivan, MSW
• Karen Sullivan, MS CCC-A
• Robert-Arne B Sullivan, MD
• Sharmin Sultana-Sattar, DC
• Eleanora Sultanova, DOE
• Summerfield PT PC

• Specialist in Staten Island, NY
• Providers in Staten Island, NY by specialty
• Specialist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2022; 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.