Provider Demographics
NPI:1184695736
Name:MUSSON, APRIL RAE (MSPT)
Entity type:Individual
Prefix:MRS
First Name:APRIL
Middle Name:RAE
Last Name:MUSSON
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:626 WATERVLIET SHAKER RD
Mailing Address - Street 2:SUITE 71
Mailing Address - City:LATHAM
Mailing Address - State:NY
Mailing Address - Zip Code:12110-3618
Mailing Address - Country:US
Mailing Address - Phone:518-877-4970
Mailing Address - Fax:518-415-1258
Practice Address - Street 1:626 WATERVLIET SHAKER RD
Practice Address - Street 2:SUITE 71
Practice Address - City:LATHAM
Practice Address - State:NY
Practice Address - Zip Code:12110-3618
Practice Address - Country:US
Practice Address - Phone:518-877-4970
Practice Address - Fax:518-415-1258
Is Sole Proprietor?:No
Enumeration Date:2006-01-31
Last Update Date:2007-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY027457225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02715511Medicaid
NYRB5018Medicare PIN