Individual
ELANA SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
55 FOGG RD, WEYMOUTH, MA 02190-2432
(781) 624-8052
(781) 624-6730
Mailing address
55 FOGG RD, WEYMOUTH, MA 02190-2432
(781) 624-8052
(781) 624-6730
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
150316
MA
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
Primary
150316
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3192423
—
MA
Enumeration date
05/03/2006
Last updated
12/16/2020
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