Individual
TIMOTHY O'SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
330 RATZER RD STE B7, WAYNE, NJ 07470-7704
(973) 317-0155
Mailing address
PO BOX 416457, BOSTON, MA 02241-6457
(844) 362-1735
(973) 290-7495
Taxonomy
Speciality
Code
Description
License number
State
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
Primary
25MA11147600
NJ
Other
Enumeration date
04/09/2017
Last updated
07/25/2022
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