Individual
HEATHER E. SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
108 COUNTY RD, EASTFORD, CT 06242-7710
(860) 315-5740
(860) 315-5741
Mailing address
108 COUNTY ROAD, PO BOX 385, EASTFORD, CT 06242
(860) 315-5740
(860) 315-5741
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
024767
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
DO1247675
—
CT
Enumeration date
07/21/2006
Last updated
04/18/2020
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