Individual
MICHAEL ROBERT SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
41 BUENA VISTA ST, STAMFORD, CT 06907-2402
(203) 316-9270
Mailing address
41 BUENA VISTA ST, STAMFORD, CT 06907-2402
Taxonomy
Speciality
Code
Description
License number
State
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Primary
PCT.0008488
CT
Other
Enumeration date
10/24/2012
Last updated
10/24/2012
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