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

Mr. Jaysen Sullivan

Individual provider Specialist · NPI 1700596897

Mr. Jaysen Sullivan is a Specialist in Staten Island, New York. Licensed in New York. Registered with an NPI since 2022.

Licensed in
NY
In the registry since
2022

Practice location Address checks out

683 Henderson Ave
Staten Island, NY 10310-1575
Phone: (718) 682-1831
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Specialist (primary) Taxonomy 174400000X · Licence $$$$$$$$$ (NY)

Record details

NPI number1700596897
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedNovember 29, 2022
Last updated in NPPESNovember 29, 2022
Certification dateNovember 29, 2022

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