Provider Demographics
NPI:1669579561
Name:CZARNY, HENRI M (MD)
Entity type:Individual
Prefix:
First Name:HENRI
Middle Name:M
Last Name:CZARNY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 BROAD ST
Mailing Address - Street 2:SUITE C4
Mailing Address - City:MILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06460
Mailing Address - Country:US
Mailing Address - Phone:203-878-7823
Mailing Address - Fax:203-877-8053
Practice Address - Street 1:203 BROAD ST
Practice Address - Street 2:SUITE C4
Practice Address - City:MILFORD
Practice Address - State:CT
Practice Address - Zip Code:06460
Practice Address - Country:US
Practice Address - Phone:203-878-7823
Practice Address - Fax:203-877-8053
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2010-09-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT0250682084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001250687Medicaid
CT010025068CT01OtherANTHEM
CT168613OtherMHN
CT168613OtherMHN
CT010025068CT01OtherANTHEM