Sullivan, Gerald Bland

Sullivan, Gerald Bland is an individual health care provider with primary practice located at 7 Kennedy Dr , Putnam CT 06260-1939. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Sullivan, Gerald Bland can be contacted via phone (860) 928-6541.

Contact Information

Primary practice address
7 Kennedy Dr Putnam CT 06260-1939
Fax: (860) 928-8268
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 024782 Connecticut

Profile Details

NPI number 1154396927
LBN Legal business name Sullivan, Gerald Bland
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 23rd, 2006
Last updated May 13th, 2013 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1154396927 NPPES
Connecticut MEDICAID 001247824

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