| Jeremiah O Sullivan Md Pc | |
|
2218 Main St Buffalo NY 14214-2635 | |
| (716) 834-4141 | |
| (716) 838-5840 |
| Full Name | Jeremiah O Sullivan Md Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 2218 Main St, Buffalo, New York |
| Authorized Official Name and Position | Jeremiah O Sullivan (PHYSICIAN) |
| Authorized Official Contact | 7168344141 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jeremiah O Sullivan Md Pc 2218 Main St Buffalo NY 14214-2635 Ph: (716) 834-4141 | Jeremiah O Sullivan Md Pc 2218 Main St Buffalo NY 14214-2635 Ph: (716) 834-4141 |
| NPI Number | 1023338118 |
|---|---|
| Provider Enumeration Date | 06/11/2010 |
| Last Update Date | 08/19/2010 |
| Medicare PECOS PAC ID | 3870627573 |
|---|---|
| Medicare Enrollment ID | O20100817000986 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023338118 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 100021 (New York) | Primary |
| Provider Name | Jeremiah O Sullivan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1104893833 PECOS PAC ID: 3274663935 Enrollment ID: I20100608000130 |
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