Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Thaddeus Joseph Sullivan, DO

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1063157717

Dr. Thaddeus Joseph Sullivan, DO is a Student in an Organized Health Care Education/Training Program in Elmira, New York. Registered with an NPI since 2022.

In the registry since
2022
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

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Practice location Address checks out

600 Roe Ave
Elmira, NY 14905-1629
Phone: (607) 442-1713
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Student in an Organized Health Care Education/Training Program (primary) Taxonomy 390200000X

Record details

NPI number1063157717
Entity typeIndividual (Type 1)
GenderMale
Credentials DO
Sole proprietorNo
NPI enumeratedApril 27, 2022
Last updated in NPPESApril 27, 2022
Certification dateApril 27, 2022

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