Individual
MRS. JENNIFER MARIE SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RRT
Contact information
Practice address
450 BROOKLINE AVE, BOSTON, MA 02215-5418
(617) 632-3403
Mailing address
450 BROOKLINE AVE, BOSTON, MA 02215-5450
(617) 632-3403
Taxonomy
Speciality
Code
Description
License number
State
227900000X
Registered Respiratory Therapist
Primary
RT4035
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0
—
MA
Enumeration date
08/08/2019
Last updated
08/08/2019
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