AIDAN SULLIVAN


Address: 1200 Driving Park Ave, Newark, NY 14513-1090
Phone: 3153592123

AIDAN SULLIVAN (NPI# 1477162725) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1477162725
Entity Type Individual
Full Name AIDAN SULLIVAN
Credential PA
Practice Address 1200 Driving Park Ave
Newark
NY 14513-1090
Mailing Address 100 Kings Hwy S
Rochester
NY 14617-5504
Practice Telephone 3153592123
Practice Fax Number 3153592167
Mailing Telephone 3153592123
Mailing Fax Number 3153592167
Enumeration Date 2020-07-23
Last Update Date 2020-09-03
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363AS0400X Physician Assistant
Specialization: Surgical Technologist
025426 NY Physician Assistants & Advanced Practice Nursing Providers

Provider Secondary Practice Location

Address Telephone Number Fax Number
2 Coulter Rd, Clifton Springs, NY 144321122 3154621472 3154622639

Office Location

Street Address 1200 DRIVING PARK AVE
City NEWARK
State NY
Zip Code 14513-1090

Providers in the same location

NPI Name Taxonomy Address Enumeration
1396741898 Lawrence N. Chessin Internal Medicine 1200 Driving Park Ave, Newark, NY 14513-1057 2005-06-21
1649898834 Nicholas D Biermann Physician Assistant 1200 Driving Park Ave, Newark, NY 14513-1090 2020-07-14
1780222604 Erin Hart Physical Therapist 1200 Driving Park Ave, Newark, NY 14513-1090 2019-12-11
1861030785 Lauren Conaty Physical Therapist 1200 Driving Park Ave, Newark, NY 14513-1090 2019-12-11
1255978540 Andrea Lorene Ide Physical Therapist 1200 Driving Park Ave, Newark, NY 14513-1090 2019-12-05
1326682618 Thomas William Jackson Mspt Physical Therapist 1200 Driving Park Ave, Newark, NY 14513-1090 2019-10-30
1578113189 Natalie A Davidson Nurse Practitioner 1200 Driving Park Ave, Newark, NY 14513 2019-09-16
1164076659 Meritt F Rogers Physician Assistant 1200 Driving Park Ave, Newark, NY 14513-1090 2019-08-01
1992366744 Allison Marie Triou Physician Assistant 1200 Driving Park Ave, Newark, NY 14513-1090 2019-06-24
1467918250 Poonam Parmar Physician Assistant 1200 Driving Park Ave, Newark, NY 14513-1090 2019-02-16
Find all providers in the same location

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1881215648 Susan Marie Oberdorf Speech-Language Pathologist 133 Elmwood, Newark, NY 14513 2020-05-04
1871077404 Aisha E Wagner Nurse Practitioner 1304 Driving Park Avenue, Newark, NY 14513 2018-09-19
1689192817 Melanie Swarthout Case Manager/Care Coordinator 150 Van Buren St., Newark, NY 14513 2017-09-08
1942650882 Donna Joy Collins I Speech-Language Pathologist 848 Pierson Avenue, Newark, NY 14513 2016-06-21
1972952661 Cj-mak Transportation, Inc. Non-emergency Medical Transport (VAN) 227 State Farm Road, Newark, NY 14513 2016-06-03
1306214473 Stephanie Belli Licensed Practical Nurse 5904 Austin Road, Newark, NY 14513 2015-09-08
1992186712 Nicole Harris Nursing Facility/Intermediate Care Facility 132 Willow Avenue, Newark, NY 14513 2015-06-17
1861802373 Jeffrey Spencer Urology 1202 Driving Park Ave Ste 5, Newark, NY 14513 2014-05-06
1609126648 Natasha Triplett Student in an Organized Health Care Education/Training Program 439 W. Maple Ave, Perkins Elementary, Newark, NY 14513 2012-09-18
1922377902 Lisa E. Williams Licensed Practical Nurse 701 Peirson Ave., Newark, NY 14513 2011-12-21
Find all providers in zip 14513

Taxonomy Information

Taxonomy Code 363AS0400X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Physician Assistant
Specialization Surgical Technologist

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1992104962 Jessica Nackley Physician Assistant 1200 Driving Park Ave Ste 4, Newark, NY 14513-1090 2014-08-15
1831304682 Geraldine Redmond Physician Assistant 150 Bergen St., E - Level Rm# E346, Newark, NJ 07103 2007-05-14
1285856716 Jill Rachel Mermagen Physician Assistant 4755 Stanton Ogletown Road, Newark, DE 19711 2007-05-03
1679794473 North Jersey Orthopaedic Group Physician Assistant 90 Bergen St Ste 1200, Newark, NJ 07103-2425 2007-05-01
1073697330 Krista Wark Rogaski Physician Assistant 90 Bergen St # 8100, Newark, NJ 07103-2425 2006-10-24
1043310527 Anthony H Hamded Physician Assistant 111 Central Ave Fl 3, Newark, NJ 07102-1909 2006-09-24
1922614981 Kalette Demarrais Physician Assistant 1096 Old Churchmans Rd, Newark, DE 19713-2102 2020-09-16
1871064352 Cassandra Barker Physician Assistant 150 Bergen St, Newark, NJ 07103-2496 2018-12-10
1881161198 Kaitlyn A Tytka Physician Assistant 1200 Driving Park Ave Ste 4, Newark, NY 14513-1090 2018-10-25
1477029353 Justin Fleegle Physician Assistant 774 Christiana Road, Suite 202, Newark, DE 19713 2018-10-18
Find all providers in NEWARK

Competitor

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City NEWARK
Zip Code 14513

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Dataset Information

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.

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