Individual
GERALD BLAND SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7 KENNEDY DR, PUTNAM, CT 06260-1939
(860) 928-6541
(860) 928-8268
Mailing address
7 KENNEDY DR, PUTNAM, CT 06260-1939
(860) 928-6541
(860) 928-8268
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
024782
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001247824
—
CT
Enumeration date
02/23/2006
Last updated
05/13/2013
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