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Individual
SHAWN CHRISTOPHER SULLIVAN
Active
Individual
SHAWN CHRISTOPHER SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
006342
CT
225100000X
Physical Therapist
PT003689
KY
225100000X
Physical Therapist
PT10441
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080006342CT01
ANTHEM BCBS
CT
01
—
3V1439
PHS HEALTHNET
CT
01
—
761899
CONNECTICARE
CT
01
—
7691516
AETNA
CT
Enumeration date
11/03/2006
Last updated
11/02/2009
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