Individual
SCOTT F SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
450 VETERANS MEMORIAL PKWY # 15B, EAST PROVIDENCE, RI 02914-5300
(401) 434-3350
(401) 434-5230
Mailing address
PROVIDER ENROLLMENT 41 MALL ROAD, BURLINGTON, MA 01805-0001
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA00259
RI
363A00000X
Physician Assistant
Primary
PA826
MA
Other
Enumeration date
06/06/2006
Last updated
07/07/2025
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