Individual
MICHAEL JOHN SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
AGACNP
Contact information
Practice address
267 GRANT ST, BRIDGEPORT, CT 06610-2870
(203) 384-3000
Mailing address
267 GRANT ST, BRIDGEPORT, CT 06610-2870
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
14369
CT
Other
Enumeration date
12/17/2024
Last updated
01/16/2025
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