Doctor Name: | LYNN M SULLIVAN |
NPI Number: | 1083873368 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | RDO |
License Number: | 5823 |
Business Practice Address: | 138 Haverhill St Room 104 Andover, MA - 018101509 |
Business Phone Number: | 9784748030 |
Business Fax Number: | 9784748031 |
Mailing Address: | 12 West Rd, MERRIMACK |
State: | NH |
Postal Code: | 030542409 |
Phone Number: | 6034240657 |
Fax Number: | 6034240657 |
NPI Enumeration Date: | 06/03/2008 |
NPI Last Update Date: | 06/03/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 156FX1800X |
License Number: | 5823 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MA |
Taxonomy Type: | Eye and Vision Services Providers |
Taxonomy Classification: | Technician/Technologist |
Taxonomy Specialization: | Optician |
Taxonomy Definition: |