Active NPI
Timothy F Sullivan
- Pharmacist
- Pawling, NY
National Provider Identifier
1285827741
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 030339
- Practice address
- 162 Route 22
Pawling, NY 12564-3211 - Phone
- (845) 855-9749
- NPI assigned
- Aug 19, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 030339 | NY | Primary |
Addresses
Primary practice location
162 Route 22
Pawling, NY 12564-3211
Mailing address
PO Box 1000
Ms3000
Portland, ME 04104-5005
Phone (207) 885-7454
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Martin'S Foods of South Burlington, LLC | Past | Accepting new patients | |
| Martins Foods of South Burlington LLC | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Community/Retail Pharmacy
- Troy, NY
- NPI 1306574215
-
- Community/Retail Pharmacy
- Pawling, NY
- NPI 1215045695
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1187481600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1187481600000",
"number": "1285827741",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1000",
"address_2": "MS3000",
"city": "PORTLAND",
"state": "ME",
"postal_code": "041045005",
"telephone_number": "207-885-7454",
"fax_number": "207-885-3121"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "162 ROUTE 22",
"city": "PAWLING",
"state": "NY",
"postal_code": "125643211",
"telephone_number": "845-855-9749"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SULLIVAN",
"first_name": "TIMOTHY",
"middle_name": "F",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-08-19",
"last_updated": "2007-08-19",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "030339",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Pawling, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.