Individual
DR. SCOTT J SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
49 LAKE AVE, GREENWICH, CT 06830-4501
(203) 869-6220
(203) 869-2672
Mailing address
49 LAKE AVE, GREENWICH, CT 06830-4501
(203) 861-2381
(203) 983-3318
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
039001
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001390012
—
CT
Enumeration date
05/04/2006
Last updated
12/05/2025
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