Individual
MR. MICHAEL GREGORY SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
30 HOBOMACK RD, QUINCY, MA 02169-2508
(617) 773-7329
Mailing address
30 HOBOMACK RD, QUINCY, MA 02169-2508
(617) 773-7329
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
RN2284306
MA
Other
Enumeration date
06/04/2015
Last updated
06/04/2015
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