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

Stanford N. Sullum MD PLLC

Organization Gynecology Physician · NPI 1417227562

Stanford N. Sullum MD PLLC provides Gynecology Physician services in New York, New York. Registered with an NPI since 2012.

In the registry since
2012
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1136 5th Ave 1B
New York, NY 10128-0122 Not confirmed with CMS for 14 years — call before visiting
Phone: (212) 876-4630
Fax: (212) 876-3478
Show map & directions

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

Specialties & licences

Gynecology Physician (primary) Taxonomy 207VG0400X

Record details

NPI number1417227562
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Stanford Sullum — Owner · (212) 876-4630
NPI enumeratedJanuary 6, 2012
Last updated in NPPESJanuary 6, 2012
Mailing address1136 5th Ave, 1b, New York, NY 10128-0122

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