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Individual
TIMOTHY FRANCIS SULLIVAN
Active
Individual
TIMOTHY FRANCIS SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.S., PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA00358
RI
363A00000X
Physician Assistant
PA4234
MA
Other
Enumeration date
07/03/2006
Last updated
03/05/2015
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