Search › New York › 174400000X
Jaysen Sullivan
NPI 1700596897 · on the registry since 2022
Practice
- Address
- 683 Henderson Ave
Staten Island, NY 10310 - Phone
- (718) 682-1831
- Organisation at this address
- Lifetime Changes Behavior Services Llc
Inferred from a shared address, not stated in the registry.
Registry record
- Primary taxonomy
- 174400000X
174400000X
- Licence states on file
- NY
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2022-11-29
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in New York