Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207KA0200X | Allergist | 57446 | MA |
NPI | 1568466324 |
---|---|
Provider Name | Dr. John S Sullivan |
First Address | Worcester, MA 01608-1209 |
Second Address | Worcester, MA 01608-1209 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/06/2005 |
Last Update Date | 03/09/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0029830 | NEIGHBORHOOD HEALTH PLAN (01) | MA |
0200248 | UNITED HEALTH CARE (01) | MA |
042923137 | TAX ID GROUP NUMBER (01) | MA |
057446 | TUFTS HEALTHPLAN (01) | MA |
2376607 | AETNA HEALTHCARE (01) | MA |
26920 | CHILDREN'S MEDICAL SECURI (01) | MA |
326051 | CIGNA HEALTHCARE (01) | MA |
6189768 | (05) | MA |
63777 | FALLON HEALTH PLAN (01) | MA |
645387 | HARVARD PILGRIM (01) | MA |
985163 | NETWORK HEALTH (01) | MA |
F71804 | (02) | MA |
J30252 | BLUE CROSS BLUE SHIELD (01) | MA |