Sullivan, Iris
Sullivan, Iris is an individual health care provider with primary practice located at 64 Whalon Street , Fitchburg MA 01420. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Sullivan, Iris can be contacted via phone (978) 809-0037.Contact Information
Primary practice address
64 Whalon Street
Fitchburg MA 01420
Phone: (978) 809-0037
Fax: (978) 829-0048
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 156837 | Massachusetts |
Profile Details
| NPI number | 1780640961 |
|---|---|
| LBN Legal business name | Sullivan, Iris |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 25th, 2006 |
| Last updated | Jul 9th, 2009 - 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1780640961 | NPPES |
| Massachusetts | MEDICAID | 3183378 |
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