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

Mallory Sullivan, PA

Individual provider Physician Assistant · NPI 1750689311

Mallory Sullivan, PA is a Physician Assistant in Providence, Rhode Island. Licensed in Rhode Island. Registered with an NPI since 2011.

Licensed in
RI
In the registry since
2011
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

593 Eddy St
Providence, RI 02903-4923
Phone: (401) 519-1604
Fax: (401) 272-0538
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA00585 (RI)

Record details

NPI number1750689311
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedMarch 7, 2011
Last updated in NPPESAugust 6, 2013
Mailing addressPo Box 9484, Providence, RI 02940-9484

Other providers in Providence