Provider Demographics
NPI:1427048529
Name:SULLI, MARIA MARZELLA (PHARMD)
Entity type:Individual
Prefix:DR
First Name:MARIA
Middle Name:MARZELLA
Last Name:SULLI
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3488 ROANOKE ST
Mailing Address - Street 2:
Mailing Address - City:SEAFORD
Mailing Address - State:NY
Mailing Address - Zip Code:11783-3001
Mailing Address - Country:US
Mailing Address - Phone:516-732-5365
Mailing Address - Fax:
Practice Address - Street 1:3266 HEMPSTEAD TPKE
Practice Address - Street 2:
Practice Address - City:LEVITTOWN
Practice Address - State:NY
Practice Address - Zip Code:11756-1345
Practice Address - Country:US
Practice Address - Phone:516-579-2111
Practice Address - Fax:516-735-5080
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-28
Last Update Date:2008-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY044567183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist