Individual
STEPHEN SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
65 ORCHARD AVE, MIDDLETOWN, RI 02842-5842
(401) 633-2690
Mailing address
65 ORCHARD AVE, MIDDLETOWN, RI 02842-5842
(401) 633-2690
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
11/03/2009
Last updated
11/03/2009
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