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DR. THADDEUS JOSEPH SULLIVAN DO
NPI 1063157717
Student in an Organized Health Care Education/Training Program in Elmira, NY

Active since April 27, 2022

NPPES record last updated: April 27, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Dr. Thaddeus Joseph Sullivan Do NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. THADDEUS JOSEPH SULLIVAN DO (NPI 1063157717) is an individual student in an organized health care education/training program in Elmira, New York and active in the NPI registry since April 2022.

NPPES Registry Identity

NPI1063157717
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameDR. THADDEUS JOSEPH SULLIVANCredential: DO
Location Address600 ROE AVEElmira, NY 14905-1629
Mailing Address111 Chapel VwClinton, NY 13323-3958
Phone(607) 442-1713
Sole ProprietorNo
Enumeration DateApril 27, 2022
NPPES CertifiedApril 27, 2022
✔ NPI 1063157717 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
600 ROE AVE, Elmira, NY 14905
Open in Google Maps ↗

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ROHAIL AIJAZ BAIG MD
Student in an Organized Health Care Education/Training Program
600 ROE AVE
ELMIRA, NY 14905
Chemung County (607) 442-1713
DR. MADIHA AKHTER
Student in an Organized Health Care Education/Training Program
600 ROE AVE
ELMIRA, NY 14905
Chemung County (607) 737-4100
DR. SANG S LEE MD
Student in an Organized Health Care Education/Training Program
600 ROE AVE
ELMIRA, NY 14905
Chemung County (607) 737-4100
SIDRAH JAMAL
Student in an Organized Health Care Education/Training Program
600 ROE AVE
ELMIRA, NY 14905
Chemung County (607) 737-4100
JOHN H CHOTKOWSKI M.D.
Radiology (Diagnostic Radiology)
600 ROE AVE
ELMIRA, NY 14905
Chemung County (607) 734-3414
ROBERT NOVAK
General Practice
600 ROE AVE
ELMIRA, NY 14905
Chemung County (607) 737-4100
JESSICA DUAN DO
Student in an Organized Health Care Education/Training Program
600 ROE AVE
ELMIRA, NY 14905
Chemung County (607) 737-4100
STEPHEN MANGANARO M.D.
Emergency Medicine
600 ROE AVE
ELMIRA, NY 14905
Chemung County (607) 737-4508

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Thaddeus Sullivan's NPI number?

The NPI number for Thaddeus Sullivan is 1063157717. It was assigned to this individual provider in the NPPES registry on April 27, 2022.

Where is Thaddeus Sullivan located?

Thaddeus Sullivan practices at 600 Roe Ave, Elmira, NY 14905. The listed phone number is (607) 442-1713.

What is Thaddeus Sullivan's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

When was this NPI record last updated?

The NPPES record for Thaddeus Sullivan was last updated on April 27, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.