Mr Mark Allen Sullivan, MBA, PT, ATC is a medicare enrolled "Specialist/technologist - Athletic Trainer" provider in Suffield, Connecticut. His current practice location is
133 Mountain Rd, Suite 2b., Suffield, Connecticut. You can reach out to his office (for appointments etc.) via phone at
(860) 254-5982.
Mr Mark Allen Sullivan is licensed to practice in Massachusetts (license number 116) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1306874227.
Healthcare Provider's Profile
| Full Name | Mr Mark Allen Sullivan |
|---|
| Gender | Male |
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| Speciality | |
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| Experience | Years |
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| Location | 133 Mountain Rd, Suffield, Connecticut |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Mr Mark Allen Sullivan attended and graduated from in
NPI Data:
- NPI Number: 1306874227
- Provider Enumeration Date: 06/29/2006
- Last Update Date: 07/08/2007
Medicare PECOS Information:
- PECOS PAC ID:
- Enrollment ID:
Medical Identifiers
Medical identifiers for Mr Mark Allen Sullivan such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1306874227 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 225100000X | Physical Therapist | 003846 (Connecticut) | Primary |
| 2251S0007X | Physical Therapist - Sports | 003846 (Connecticut) | Primary |
| 2251X0800X | Physical Therapist - Orthopedic | 003846 (Connecticut) | Primary |
| 2255A2300X | Specialist/technologist - Athletic Trainer | 116 (Massachusetts) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Mark Allen Sullivan is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Mr Mark Allen Sullivan, MBA, PT, ATC
40 Hearthstone Dr,
Agawam, MA 01001-3238
Ph: (413) 789-2168 | Mr Mark Allen Sullivan, MBA, PT, ATC
133 Mountain Rd, Suite 2b.,
Suffield, CT 06078-2084
Ph: (860) 254-5982 |
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