Sandra J Sullivan, DT
Individual provider Active NPI Registered Dietitian · Oakville, CT
NPI 1700913035 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1700913035
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Dietitian 133V00000X
- License
- 000778 (CT)
- Practice address
- 900 Main St
Oakville, CT 06779-1999 - Phone
- (860) 945-3012
- Fax
- (860) 945-9854
- NPI assigned
- Feb 27, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 000778 | CT | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Therapy Unlimited-Children'S Therapy Center | Dietitian, Registered | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 000778 | CT | Yes |
Addresses
Primary practice location
900 Main St
Oakville, CT 06779-1999
Mailing address
PO Box 425
Watertown, CT 06795-0425
Phone (860) 945-3012
Other providers in Oakville, CT
- Kerry Catherine Rutland
- Andrew Michael Shurretto
- Robin Skowronski
- Sara J Skudzienski
- Meaghan Jeannette Spagnolo
- Maristane A Tedesco
- Therapy Unlimited-Children'S Therapy Center
- Three Thistles Counseling LLC
- Victoria Tofield
- Nicole Lillian Tomasetti
All providers in Oakville, CT · Registered Dietitian in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.