DR. SCOTT J SULLIVAN (NPI# 1790733822) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790733822 |
| Entity Type | Individual |
| Full Name | DR. SCOTT J SULLIVAN |
| Credential | M.D. |
| Practice Address |
49 Lake Ave Greenwich CT 06830-4501 |
| Practice Telephone | 2038696220 |
| Practice Fax Number | 2038692672 |
| Mailing Telephone | 2038612381 |
| Mailing Fax Number | 2039833318 |
| Enumeration Date | 2006-05-04 |
| Last Update Date | 2010-09-14 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
039001 | CT | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | 001390012 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265950737 | Scott Jeffrey Sullivan | Dentist | 3516 S 47th St Ste 104, Tacoma, WA 98409-4427 | 2017-09-06 |
| 1477070522 | Scott Sullivan | Physical Therapist | 5320 Mark Dabling Blvd # 100, Colorado Springs, CO 80918-3839 | 2017-08-29 |
| 1063612844 | Scott Louis Sullivan | Dentist | 76 Doctors Park Dr., Santa Rosa, CA 95405-6615 | 2007-07-20 |
| 1154344000 | Scott Keith Sullivan Jr. | Surgery | 1717 Saint Charles Ave, New Orleans, LA 70130-5223 | 2006-07-25 |
| 1972134567 | Scott R Sullivan | Student in an Organized Health Care Education/Training Program | 5200 Harry Hines Blvd, Dallas, TX 75235-7709 | 2020-02-01 |
| 1770056608 | Scott Lamar Sullivan | Counselor | 7000b S Center Dr, Clearlake, CA 95422-8131 | 2019-01-03 |
| 1386143899 | Scott Sullivan | Counselor | 4455 Ne Highway 20, Corvallis, OR 97330-9695 | 2018-02-10 |
| 1689100471 | Scott Sullivan | Student in an Organized Health Care Education/Training Program | 2390 W Congress St, Lafayette, LA 70506-4205 | 2017-05-11 |
| 1932467123 | Scott Sullivan | Student in an Organized Health Care Education/Training Program | 9040 Fitzsimmons Dr, Joint Base Lewis Mcchord, WA 98431-1000 | 2012-04-25 |
| 1033496179 | Scott Patric Sullivan | Specialist/Technologist | 205 S Main St, Suite C, Longmont, CO 80501-1716 | 2011-11-03 |
| Street Address |
49 LAKE AVE |
| City | GREENWICH |
| State | CT |
| Zip Code | 06830-4501 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508860859 | Stephen Jeffrey Salzer | Otolaryngology | 49 Lake Ave, Greenwich, CT 06830-4501 | 2005-06-01 |
| 1255761482 | Joshua Jablonski | Audiologist | 49 Lake Ave, Suite 103, Greenwich, CT 06830-4501 | 2013-11-25 |
| 1366714180 | Lynne M Haven Md PC | Dermatology | 49 Lake Ave, Greenwich, CT 06830-4501 | 2012-02-09 |
| 1730408261 | Kameron Robert Shahid | Radiology | 49 Lake Ave, Greenwich, CT 06830-4501 | 2010-05-24 |
| 1770802357 | Catherine Michels Alonzo | Urology | 49 Lake Ave, Suite 201, Greenwich, CT 06830-4501 | 2010-05-22 |
| 1194053942 | Center for Oral and Implant Surgery of Greenwich, LLC | Clinic/Center | 49 Lake Ave, Greenwich, CT 06830-4501 | 2009-12-04 |
| 1477799302 | True Care Medical Practice, Inc. | Internal Medicine | 49 Lake Ave, Suite 1b, Greenwich, CT 06830-4501 | 2008-12-24 |
| 1861667016 | Incoronata Lileika | Audiologist | 49 Lake Ave, Greenwich, CT 06830-4501 | 2008-04-29 |
| 1356538607 | Greenwich Neurology | Specialist | 49 Lake Ave, Suite 2-27, Greenwich, CT 06830-4501 | 2007-10-01 |
| 1538353321 | Associates of Otolaryngology PC | Otolaryngology | 49 Lake Ave, Suite 205, Greenwich, CT 06830-4501 | 2007-09-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992303341 | Cristina Castagna | Physical Therapist | 500 West Putnam Ave, 3rd Floor, Greenwich, CT 06830 | 2020-10-16 |
| 1194334334 | Cognitive and Behavioral Care Center, LLC | Counselor | 55 Old Post Road #2, Suite 2c, Greenwich, CT 06830 | 2020-07-23 |
| 1245866433 | Barbara Edeson Roth | Speech-Language Pathologist | The Nathaniel Witherell Home, 70 Parsonage Road, Greenwich, CT 06830 | 2020-03-19 |
| 1750938932 | Evelyn Ramos | Licensed Practical Nurse | 111 Wilbur Peck Ct, Greenwich, CT 06830 | 2019-08-21 |
| 1134773674 | Alexandra Blair Conway | Psychologist | 55 Holly Hill Lane Suite 170, Greenwich, CT 06830 | 2019-08-01 |
| 1821560871 | Brionna Emily Lyles | Licensed Practical Nurse | 111 Wilbur Court, Greenwich, CT 06830 | 2018-12-31 |
| 1568959815 | Backcountry Wellness Inc. | Social Worker | 7 Lincoln Avenue, Greenwich, CT 06830 | 2018-04-21 |
| 1316455876 | Hillary Rea Bercovici | Counselor | 8 Sound Shore Dr Ste 130, Greenwich, CT 06830 | 2018-01-18 |
| 1689181083 | Coastal Eye Surgeons LLC | Ophthalmology | 600 W Putnam Ave Lowr Level, Greenwich, CT 06830 | 2018-01-07 |
| 1952853814 | Tina M. Crystal | Psychologist | 75 Holly Hill Lane, Suite 300, Greenwich, CT 06830 | 2016-10-26 |
| Find all providers in zip 06830 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063807592 | Halley Marisa Hindman | Radiology | 5 Perryridge Rd, Greenwich, CT 06830-4608 | 2015-04-01 |
| 1962827162 | Sarah Goodman I | Radiology | 644 W Putnam Ave, Greenwich, CT 06830 | 2014-02-25 |
| 1730408261 | Kameron Robert Shahid | Radiology | 49 Lake Ave, Greenwich, CT 06830-4501 | 2010-05-24 |
| 1811131006 | Birva A Straub | Radiology | 5 Perryridge Rd, Medical Education, Greenwich, CT 06830-4608 | 2009-05-01 |
| 1528262219 | Kapil Rajendra Desai | Radiology | 49 Lake Ave, Greenwich, CT 06830-4501 | 2007-06-14 |
| 1326260910 | Mahan Mathur | Radiology | 5 Perryridge Rd, Medical Education, Greenwich, CT 06830-4608 | 2007-05-03 |
| 1679794796 | Maddalena Pizzirusso Duarte | Radiology | 5 Perryridge Rd, Medical Education, Greenwich, CT 06830-4608 | 2007-05-02 |
| 1831147438 | Laura J Hodges | Radiology | 49 Lake Ave, Greenwich, CT 06830-4501 | 2006-05-05 |
| 1891753240 | David Joshua Mullen | Radiology | 49 Lake Ave, Greenwich, CT 06830-4501 | 2006-05-03 |
| 1053379404 | David D Evans | Radiology | 49 Lake Ave, Greenwich, CT 06830-4501 | 2006-05-03 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.