Individual
KEVIN SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
313 SPEEN ST, ORTHOPEDICS NEW ENGLAND, NATICK, MA 01760-1538
(508) 655-0471
(508) 650-3547
Mailing address
313 SPEEN ST, ORTHOPEDICS NEW ENGLAND, NATICK, MA 01760-1538
(508) 655-0471
(508) 650-3547
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
156166
MA
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
156166
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0146447
—
MA
Enumeration date
08/15/2005
Last updated
11/07/2024
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