Individual
THOMAS S SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
481 FERRY ST, MALDEN, MA 02148-7851
(781) 605-0505
(781) 605-3458
Mailing address
1377 DORCHESTER AVE 2FL, BOSTON, MA 02122-2950
(617) 822-0900
(617) 822-0800
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
385
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11609670
CAQH
—
01
—
720367
TUFTS
—
01
—
AA61550
HARVARD PHC
—
01
—
Y35231
BC/BS
—
Enumeration date
08/29/2006
Last updated
07/21/2022
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