Healthcare Provider Details

I. General information

NPI: 1023149028
Provider Name (Legal Business Name): ALICIA JEAN SULLIVAN PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ALICIA JEAN DIROBBIO PT, DPT

II. Dates (important events)

Enumeration Date: 03/08/2007
Last Update Date: 05/29/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40 N MAIN ST
BELLINGHAM MA
02019-1590
US

IV. Provider business mailing address

40 N MAIN ST
BELLINGHAM MA
02019-1590
US

V. Phone/Fax

Practice location:
  • Phone: 508-966-2717
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number15318
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT01599
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: