PETER SULLIVAN (NPI# 1538664016) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538664016 |
| Entity Type | Individual |
| Full Name | PETER SULLIVAN |
| Credential | MD |
| Practice Address |
55 Lake Ave N Worcester MA 01655-0002 |
| Practice Telephone | 5083341000 |
| Mailing Telephone | 7744422173 |
| Mailing Fax Number | 7744426781 |
| Enumeration Date | 2018-03-27 |
| Last Update Date | 2018-04-11 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407071194 | Peter E Sullivan | Counselor | 44 Myrtle Ter, Winchester, MA 01890-3157 | 2007-04-16 |
| 1558468322 | Peter Damian Sullivan | Hospitalist | 3181 Sw Sam Jackson Park Rd # Bte119, Portland, OR 97239-3011 | 2006-09-20 |
| 1992320857 | Peter Sullivan | Student in an Organized Health Care Education/Training Program | 1500 Lansdowne Ave, Darby, PA 19023-1200 | 2020-06-16 |
| 1306292024 | Peter Sullivan | Anesthesiology | Kumc 3901 Rainbow Blvd Ms 1034, Kansas City, KS 66160-0001 | 2016-05-12 |
| 1205201688 | Peter Joshua Sullivan | Social Worker | 5500 Armstrong Rd, Battle Creek, MI 49037-7314 | 2015-12-10 |
| 1225439300 | Peter Sullivan | Pharmacist | 1275 York Ave, New York, NY 10065-6007 | 2014-09-09 |
| 1871895870 | Peter Vaughn Sullivan | Counselor | 4020 Civic Center Dr, San Rafael, CA 94903-4173 | 2010-11-23 |
| 1235399221 | Peter David Sullivan | Occupational Therapist | 1115 Capitola Rd, Santa Cruz, CA 95062-2844 | 2008-06-12 |
| 1578603478 | Peter D Sullivan | Emergency Medicine | 7007 Powers Blvd, Parma, OH 44129-5437 | 2007-02-08 |
| 1437250412 | Peter J Sullivan | Physician Assistant | 927 Franklin St Se, The Orthopaedic Center, Huntsville, AL 35801-4306 | 2006-09-25 |
| Street Address |
55 LAKE AVE N |
| City | WORCESTER |
| State | MA |
| Zip Code | 01655-0002 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477556587 | James E Liebmann | Internal Medicine | 55 Lake Ave N, Hematology/oncology, Worcester, MA 01655-0002 | 2005-05-23 |
| 1518568732 | Justin Bullard | Psychologist | 55 Lake Ave N, Worcester, MA 01655-0002 | 2020-11-04 |
| 1346849825 | Meghan Moore | Nurse Practitioner | 55 Lake Ave N, Worcester, MA 01655-0002 | 2020-10-26 |
| 1174122899 | Jessica Goncalves Ferreira | Nurse Practitioner | 55 Lake Ave N, Worcester, MA 01655-0002 | 2020-10-23 |
| 1235746686 | Desiree Mytych | Student in an Organized Health Care Education/Training Program | 55 Lake Ave N, Worcester, MA 01655-0002 | 2020-09-29 |
| 1659986248 | Rebecca Lynn Harris | Student in an Organized Health Care Education/Training Program | 55 Lake Ave N, Worcester, MA 01655-0002 | 2020-09-10 |
| 1639781487 | Gabriella Kathleen Holland | Student in an Organized Health Care Education/Training Program | 55 Lake Ave N, Worcester, MA 01655-0002 | 2020-08-21 |
| 1730791898 | Kerry Anne Benedict | Speech-Language Pathologist | 55 Lake Ave N, Worcester, MA 01655-0002 | 2020-08-20 |
| 1902418999 | Natasha R. Turner | Genetic Counselor, MS | 55 Lake Ave N, Worcester, MA 01655-0002 | 2020-08-20 |
| 1144830712 | Abbey Corsini | Nurse Practitioner | 55 Lake Ave N, Worcester, MA 01655-0002 | 2020-08-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205489713 | Darryl Sweeper Jr. | Student in an Organized Health Care Education/Training Program | 55 Lake Avenue North, Psychiatry, Umass Memorial Medical Center, Worcester, MA 01655 | 2019-07-23 |
| 1225690530 | Ryan Zenevitch | Student in an Organized Health Care Education/Training Program | 55 Lake Avenue North, Family Medicine, Umass Memorial Medical Center, Worcester, MA 01655 | 2019-07-08 |
| 1932688454 | Victoria Sayeg | Student in an Organized Health Care Education/Training Program | 55 Lake Avenue North, Pediatrics, Worcester, MA 01655 | 2018-08-07 |
| 1114425675 | Judith Dio Wentzell | Social Worker | Umassmemorial Medical Center, 55 Lake Ave North, Dept of Care Coordination, Worcester, MA 01655 | 2018-01-30 |
| 1861927386 | Muhammad Waqas Khan | Student in an Organized Health Care Education/Training Program | University of Massachusetts 55 North Lake Ave, Neurology, Worcester, MA 01655 | 2017-04-21 |
| 1861806192 | Qaiser Shamshir Khan | Psychiatry & Neurology | 55 Lake Ave N # S7-831, Worcester, MA 01655 | 2014-06-14 |
| 1073858981 | Heidi Glover | Nurse Practitioner | 55 Lake Ave North Dept. of Pedi-adolescent, Ummc University Campus, Worcester, MA 01655 | 2012-12-04 |
| 1972867992 | Anna Bjornsdottir | Psychiatry & Neurology | 55 Lake Av N, Worcester, MA 01655 | 2012-06-25 |
| 1245567676 | Steven Edward Mckinley | Nurse Practitioner | 55 Lake Ave. North, Umass Memorial Medical Center University Campus, Worcester, MA 01655 | 2009-11-05 |
| 1851582951 | Robin I Davidson | Neurological Surgery | 55 Lake Ave, North, Ummhc-univ Campus, Worcester, MA 01655 | 2007-08-05 |
| Find all providers in zip 01655 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326661927 | Ekaterina V Pimental | Student in an Organized Health Care Education/Training Program | 72 Salisbury St Apt 5, Worcester, MA 01609-3134 | 2020-05-19 |
| 1841810900 | Charles Purcell | Student in an Organized Health Care Education/Training Program | 80 Carter Rd, Worcester, MA 01609-1038 | 2020-04-19 |
| 1942839832 | Nicole Elizabeth Lewandrowski | Student in an Organized Health Care Education/Training Program | Pathology-1 Innovation Drive, Biotech 3, Worcester, MA 01604 | 2020-04-03 |
| 1982232336 | Min Zhang | Student in an Organized Health Care Education/Training Program | 1 Innovation Dr. Biotech 3, Worcester, MA 01605-4306 | 2020-03-31 |
| 1336777952 | Zhenwei Zhang | Student in an Organized Health Care Education/Training Program | 1 Innovation Dr Ste 2, Worcester, MA 01605-4306 | 2020-03-30 |
| 1932736634 | Gregory Stephen Kazarian | Student in an Organized Health Care Education/Training Program | 2 Marissa Cir, Worcester, MA 01604-2674 | 2020-03-24 |
| 1376178590 | Seungju Oh | Student in an Organized Health Care Education/Training Program | 55 Lake Ave N # S4-740, Worcester, MA 01655-0002 | 2020-03-09 |
| 1962032946 | Samuel James Casey | Student in an Organized Health Care Education/Training Program | 4 Normal St Apt 2, Worcester, MA 01605-3496 | 2020-01-18 |
| 1265072169 | Klajdi Kosovrasti | Student in an Organized Health Care Education/Training Program | 46 Fox Meadow Dr, Worcester, MA 01602-2242 | 2020-01-09 |
| 1669012449 | Jacob Moninghoff | Student in an Organized Health Care Education/Training Program | 16 Norton St Apt 1, Worcester, MA 01605-3780 | 2020-01-09 |
| Find all providers in WORCESTER | ||||
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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.