DR. KELLY C SULLIVAN (NPI# 1407064595) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407064595 |
| Entity Type | Individual |
| Full Name | DR. KELLY C SULLIVAN |
| Credential | PHARMD |
| Practice Address |
100 Amsterdam Commons Amsterdam NY 12010 |
| Practice Telephone | 5187707181 |
| Practice Fax Number | 5187707181 |
| Mailing Telephone | 5187707181 |
| Mailing Fax Number | 5187707181 |
| Enumeration Date | 2007-05-20 |
| Last Update Date | 2010-03-04 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 183500000X | Pharmacist | PS39975 | FL | Pharmacy Service Providers |
| Y | 183500000X | Pharmacist | 048152 | NY | Pharmacy Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144832205 | Kelly E Sullivan | Nurse Practitioner | 10020 Southern Maryland Blvd Ste 202, Dunkirk, MD 20754-3055 | 2020-08-20 |
| 1124670724 | Kelly Elizabeth Sullivan | Occupational Therapy Assistant | 12 Deforest Rd, Lansdowne, PA 19050-2109 | 2019-07-12 |
| 1427549088 | Kelly Elizabeth Sullivan | Nurse Practitioner | 428 Hartford Tpke Ste 207, Vernon, CT 06066-4841 | 2018-05-19 |
| 1134642267 | Kelly Glen Sullivan | Durable Medical Equipment & Medical Supplies | 3345 Seajay Dr, Beavercreek, OH 45430-1365 | 2017-07-20 |
| 1831636778 | Kelly Sullivan | Assistant Behavior Analyst | 273 Powell Cir, Berlin, MD 21811-1185 | 2017-01-30 |
| 1396197521 | Kelly Sullivan | Speech-Language Pathologist | 82 Ridgecrest Dr, Pittsburgh, PA 15235-4548 | 2016-07-12 |
| 1548657851 | Kelly Sullivan | Speech-Language Pathologist | 1021 Wind River Pkwy, Morrisville, NC 27560-8233 | 2015-04-24 |
| 1568867877 | Kelly Sullivan | Speech-Language Pathologist | 14105 Snow Rd, Brookpark, OH 44142-2557 | 2014-10-29 |
| 1053713024 | Kelly Goodrich Sullivan | Physical Therapist | 2035 Gayle Pl, Clearwater, FL 33763-4217 | 2014-09-22 |
| 1730595752 | Kelly Sullivan | Registered Nurse | 8 Jacqueline Ct, Port Jefferson Station, NY 11776-3117 | 2014-07-10 |
| Street Address |
100 AMSTERDAM COMMONS |
| City | AMSTERDAM |
| State | NY |
| Zip Code | 12010 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083862080 | Cvs Albany LLC | Pharmacy | 100 Amsterdam Commons, Amsterdam, NY 12010 | 2008-09-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447863816 | Julia Subik | Nurse Practitioner | 3768 Ny-30, Amsterdam, NY 12010 | 2020-08-26 |
| 1124674957 | Jessica Lee Benoit | Family Medicine | 5010 Ny-30, Amsterdam, NY 12010 | 2019-08-16 |
| 1679138986 | Martha Maria Staring | Counselor | 4988 Ny-30, Amsterdam, NY 12010 | 2019-05-02 |
| 1982169991 | Courtney Caralynn Paton | Nurse Practitioner | 446 B Guy Park Avenue, Amsterdam, NY 12010 | 2019-02-04 |
| 1053845628 | Linda Sue Sperow | Registered Nurse | 341 Church St., Amsterdam, NY 12010 | 2017-04-20 |
| 1376902734 | Nysarc Inc Montgomery County Chapter Liberty | Clinic/Center | 47 Liberty Dr, Amsterdam, NY 12010 | 2016-02-15 |
| 1780050880 | Pamela T Wadsworth | Occupational Therapist | 47 Liberty Drive, Amsterdam, NY 12010 | 2015-08-12 |
| 1366791600 | Nicole Cadwell | Licensed Practical Nurse | 34 Finlay St, Amsterdam, NY 12010 | 2012-08-31 |
| 1700147428 | Noah Reiss Md PC | Allergy & Immunology | 4456 State Hwy 30, Amsterdam, NY 12010 | 2012-05-30 |
| 1265723738 | Amy Martelle | Speech-Language Pathologist | 11 Liberty Street, Greater Amsterdam School District, Amsterdam, NY 12010 | 2011-05-02 |
| Find all providers in zip 12010 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710209531 | Amanda D'aniello | Pharmacist | 4192 St Hwy 30, Amsterdam, NY 12010-1820 | 2010-02-21 |
| 1073769006 | Robert Cherico | Pharmacist | 141 Sanford Farm Shopping Plaza, Price Chopper Pharmacy 139, Amsterdam, NY 12010-2120 | 2008-08-11 |
| 1417139940 | Mary Jo List | Pharmacist | 101 Sanford Farms Shopping Ctr, Amsterdam, NY 12010-7535 | 2007-11-27 |
| 1871773770 | Phillip Anthony Iannon | Pharmacist | 4894 State Highway 30, Amsterdam, NY 12010-7515 | 2007-11-07 |
| 1013196583 | Kayoko Lomanto | Pharmacist | 149 Market St, Amsterdam, NY 12010-3626 | 2007-10-31 |
| 1669665915 | Heidi L Hunt | Pharmacist | 115 Hannaford Plaza, Amsterdam, NY 12010 | 2007-08-21 |
| 1104019454 | Melissa J Sweet | Pharmacist | 4901 State Highway 30, Amsterdam, NY 12010-7541 | 2007-08-21 |
| 1235738212 | Corey Sweet | Pharmacist | 101 Sanford Farms Shopping Ctr, Amsterdam, NY 12010-7535 | 2020-10-21 |
| 1164875753 | Kacie Ellen Edwards | Pharmacist | 101 Sanford Farms Shopping Ctr, Amsterdam, NY 12010-7535 | 2016-07-19 |
| 1558714345 | Carolyn Virginia Enos | Pharmacist | 4999 State Highway 30, Amsterdam, NY 12010-7521 | 2016-07-18 |
| Find all providers in AMSTERDAM | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.