Mallory Sullivan, DO is a medicare enrolled "Family Medicine" physician in Waterville, New York. Her current practice location is
117 W Main St, Suite 1, Waterville, New York. You can reach out to her office (for appointments etc.) via phone at
(315) 841-4178.
Mallory Sullivan is licensed to practice in New York (license number 274601) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1124311360.
Physician's Profile
Full Name | Mallory Sullivan |
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Gender | Female |
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Speciality | |
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Experience | Years |
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Location | 117 W Main St, Waterville, New York |
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Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Medical Education and Training:
- Mallory Sullivan attended and graduated from in
NPI Data:
- NPI Number: 1124311360
- Provider Enumeration Date: 05/20/2011
- Last Update Date: 03/20/2017
Medicare PECOS Information:
- PECOS PAC ID:
- Enrollment ID:
Medical Identifiers
Medical identifiers for Mallory Sullivan such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1124311360 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
207Q00000X | Family Medicine | 274601 (New York) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mallory Sullivan is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Mallory Sullivan, DO 117 W Main St, Suite 1, Waterville, NY 13480-1165 Ph: (315) 841-4178 | Mallory Sullivan, DO 117 W Main St, Suite 1, Waterville, NY 13480-1165 Ph: (315) 841-4178 |
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