IndividualActive
Nicolette Sullivan, CTRS
NPI 1609395714 · Recreation Therapist · Oswego, NY
Provider details
- NPI number
- 1609395714
- Entity type
- Individual
- Primary specialty
- Recreation TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Credential
- CTRS
- Sex
- Female
- Sole proprietor
- Yes
- License
- 69933 (NY)
Specialties & taxonomies
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Profile Score
Established profile(69/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
8 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
159 W 1st St
Oswego, NY 13126-2045
Phone: (315) 342-9575
Street-level locationGet directions
Mailing address
309 Crenshaw Ct
Camillus, NY 13031-2041
Registry dates
- Enumerated
- 2017-09-11
- Last updated
- 2017-09-11
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.