Dr. John L Sullivan
Pediatric Allergist
55 Lake Ave N Department Of Pediatric Allergy & Immunology
Worcester
, Massachusetts 01655-0002
Dr. John L Sullivan
Pediatric Allergist
55 Lake Ave N Department Of Pediatric Allergy & Immunology
Worcester
, Massachusetts 01655-0002
(508) 334-1977
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About
Features
Specialties
- Pediatric Allergist
Languages spoken
- English
Location
First Address
- Dr. John L Sullivan
- Po Box 415348
- Boston, MA
- Zip : 02241-0001
- Fax : (508) 334-1977
- Phone : (800) 225-8885
Second Address
- Dr. John L Sullivan
- 55 Lake Ave N Department Of Pediatric Allergy & Immunology
- Worcester, MA
- Zip : 01655-0002
- Fax : (508) 856-5004
- Phone : (508) 856-1572
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 2080P0201X | Pediatric Allergist | 42650 | MA |
National Provider Identifier
| NPI | 1821072547 |
|---|---|
| Provider Name | Dr. John L Sullivan |
| First Address | Boston, MA 02241-0001 |
| Second Address | Worcester, MA 01655-0002 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 06/12/2005 |
| Last Update Date | 09/11/2020 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 2061902 | (05) | MA |
| E02102 | (02) | MA |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.