Individual
TIMOTHY W SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
155 BORTHWICK AVE, SUITE 200 E, PORTSMOUTH, NH 03801-7156
(603) 436-1773
(603) 427-0655
Mailing address
155 BORTHWICK AVE, SUITE 200 E, PORTSMOUTH, NH 03801-7156
(603) 436-1773
(603) 427-0655
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
16565
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3098071
—
NH
Enumeration date
04/27/2010
Last updated
05/11/2020
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