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

Nanako Shannon Sullivan, PA

Individual provider Physician Assistant · NPI 1871277780

Nanako Shannon Sullivan, PA is a Physician Assistant in Brooklyn, New York. Practices as a sole proprietor. Licensed in New York.

Licensed in
NY
In the registry since
2023
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

760 Broadway
Brooklyn, NY 11206-5383
Phone: (718) 963-8000
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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 034283 (NY)

Record details

NPI number1871277780
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorYes
NPI enumeratedJune 12, 2023
Last updated in NPPESAugust 21, 2025
Certification dateAugust 21, 2025

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