Mack Lee Sullivan, M.D.
Physical Medicine & Rehabilitation in Eastchester, NY. Individual provider (NPI-1).
NPI number1881616068
StatusActive
Last updated in NPPESJan 1, 2026
Details
- NPI
- 1881616068
- Entity type
- Individual (NPI-1)
- Name
- Mack Lee Sullivan
- Credential
- M.D.
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jul 24, 2006
- Certification date
- Jan 1, 2026
- Last updated
- Jan 1, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 208100000X | Physical Medicine & Rehabilitation | 203477 | NY | Yes |
| 207QG0300X | Family Medicine, Geriatric Medicine | 203477 | NY | |
| 208D00000X | General Practice | 203477 | NY | |
| 207P00000X | Emergency Medicine | 203477-1 | NY |
Practice location
369 White Plains RdEastchester, NY 10709-2805
Phone 914-395-3691 · Fax 914-395-3693
Mailing address
369 White Plains RdEastchester, NY 10709-2805
Phone 914-395-3691 · Fax 914-395-3693
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