Carly Elizabeth Sullivan, PA-C
Physician Assistant, Medical in Brockton, MA. Individual provider (NPI-1).
NPI number1346124591
StatusActive
Last updated in NPPESAug 1, 2025
Details
- NPI
- 1346124591
- Entity type
- Individual (NPI-1)
- Name
- Carly Elizabeth Sullivan
- Credential
- PA-C
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Aug 1, 2025
- Certification date
- Aug 1, 2025
- Last updated
- Aug 1, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363AM0700X | Physician Assistant, Medical | – | – | Yes |
Practice location
680 Centre StBrockton, MA 02302-3395
Phone 508-941-7000
Mailing address
20 Shore DrTaunton, MA 02780-1142
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