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General NPI Number Information
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NPI Number | 1679459671
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Entity Type | Individual
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Provider Name | ALEXANDER SULLIVAN PT, DPT
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Gender | Male
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Dates
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Enumeration Date | 08/14/2025
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Last Update Date | 10/08/2025
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Provider Practice Location Address
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Address Line | 300 WILSON AVE BLDG B
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City | NORWALK
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State | CT
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Zip | 06854-4631
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Country | US
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Telephone | 212-203-6802
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Fax |
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Provider Business Mailing Address
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Address Line | 1690 2ND AVE FRNT 3
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City | NEW YORK
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State | NY
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Zip | 10128-5950
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Country | US
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Telephone | 212-203-6802
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Fax | 212-377-5741
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 14995
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License Number State | CT
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