Sullivan, Scott J
Sullivan, Scott J is an individual health care provider with primary practice located at 49 Lake Ave , Greenwich CT 06830-4501. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Sullivan, Scott J can be contacted via phone (203) 869-6220.Contact Information
Primary practice address
49 Lake Ave
Greenwich CT 06830-4501
Phone: (203) 869-6220
Fax: (203) 869-2672
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | 039001 | Connecticut |
Profile Details
| NPI number | 1790733822 |
|---|---|
| LBN Legal business name | Sullivan, Scott J |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 4th, 2006 |
| Last updated | Sep 14th, 2010 - about 16 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1790733822 | NPPES |
| Connecticut | MEDICAID | 001390012 |
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