John Sullivan
Oral and Maxillofacial Pathology
1842 Beacon St
Brookline
, Massachusetts 02445-1930
John Sullivan
Oral and Maxillofacial Pathology
1842 Beacon St
Brookline
, Massachusetts 02445-1930
(617) 730-8482
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About
Features
Specialties
- Oral and Maxillofacial Pathology
Languages spoken
- English
Location
First Address
- John Sullivan
- 1842 Beacon St
- Brookline, MA
- Zip : 02445-1930
- Fax : (617) 730-8482
- Phone : (617) 566-5445
Second Address
- John Sullivan
- 1842 Beacon St
- Brookline, MA
- Zip : 02445-1930
- Fax : (617) 730-8482
- Phone : (617) 566-5445
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 1223P0106X | Oral and Maxillofacial Pathology | 8957 | MA |
National Provider Identifier
| NPI | 1508086760 |
|---|---|
| Provider Name | John Sullivan |
| First Address | Brookline, MA 02445-1930 |
| Second Address | Brookline, MA 02445-1930 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 27/04/2007 |
| Last Update Date | 08/07/2007 |
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.