Provider Demographics
NPI:1508403908
Name:MUSHI, HENRY
Entity Type:Individual
Prefix:
First Name:HENRY
Middle Name:
Last Name:MUSHI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1153 EAST ST S
Mailing Address - Street 2:
Mailing Address - City:SUFFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06078-2412
Mailing Address - Country:US
Mailing Address - Phone:860-270-9880
Mailing Address - Fax:
Practice Address - Street 1:1153 EAST ST S
Practice Address - Street 2:
Practice Address - City:SUFFIELD
Practice Address - State:CT
Practice Address - Zip Code:06078-2412
Practice Address - Country:US
Practice Address - Phone:860-270-9880
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-04
Last Update Date:2020-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2277823163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health