Sullivan, Eugene David

Sullivan, Eugene David is an individual health care provider with primary practice located at 1000 Asylum Ave Suite 2120, Hartford CT 06105. He recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Surgery. Allopathic & Osteopathic Physicians / Surgery is his primary health care specialty. Sullivan, Eugene David can be contacted via phone (860) 246-4000.

Contact Information

Primary practice address
1000 Asylum Ave Suite 2120 Hartford CT 06105
Phone: (860) 246-4000
Fax: (860) 527-6985
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 021621 Connecticut
Allopathic & Osteopathic Physicians / Surgery 208600000X 021621 Connecticut

Profile Details

NPI number 1255370326
LBN Legal business name Sullivan, Eugene David
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 5th, 2006
Last updated Jul 7th, 2010 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1255370326 NPPES
Connecticut MEDICAID 001216217

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