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1730179607

NPI Code Detail

MEDICARE: JAMES D SULLIVAN MD

MEDICARE: JAMES D SULLIVAN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207P00000X	Emergency Medicine Physician	72262	MA
2	207R00000X	Internal Medicine Physician	MD09038	RI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	45468	OTHER	MA	HPHC
2	J10322	OTHER	MA	BCBS
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	404886	OTHER	MA	TUFTS

General Provider Information

NPI Number	:	1730179607
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES D SULLIVAN MD

Provider Business Mailing Address
First Line	:	3 CENTURY DR
Second Line	:
City	:	PARSIPPANY
State	:	NJ
Zip	:	07054-4610
Country	:	US
Telephone Number	:	973-251-1018
Fax Number	:	973-740-9895

Provider Business Practice Location Address
First Line	:	200 HIGH SERVICE AVE
Second Line	:
City	:	NORTH PROVIDENCE
State	:	RI
Zip	:	02904-5113
Country	:	US
Telephone Number	:	401-456-3402
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/24/2005
Last Update Date	:	04/01/2013

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Directions to “ JAMES D SULLIVAN MD” Practice Location

Language	Start Address	Practice Location

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