# MR. HENRY SISUN

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1235110073
- **Gender:** Man
- **Credential:** M.S.P.T.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | 5669 | MA | — |
| 225100000X | Physical Therapist | PT00646 | RI | Yes |

## Other

- **Enumeration date:** 11/09/2005
- **Last updated:** 09/27/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1454-35-0001 | DMERC ID \# | RI |
| 01 | — | 19016 | NEIGHBORHOOD HEALTH PLAN | — |
| 01 | — | 2015585 | AETNA PROV ID\# | RI |
| 01 | — | 401280 | RI BLUECHIP PROV \# | RI |
| 01 | — | 5669 | PT LICENSE STATE OF MA | MA |
| 01 | — | 5712442 | AETNA INDIVIDUAL \# | MA |
| 01 | — | 605716 | HPHC MA PROV ID\# | MA |
| 01 | — | 70151140002 | CIGNA NON-PAR | — |
| 01 | — | 7536 | RI BCBS PROV \# | RI |
| 01 | — | AA46223 | HPHC RI PROV ID\# | RI |
| 01 | — | PT00646 | PT LICENSE \# STATE OF RI | RI |
| 01 | — | PT0182 | MEDICARE GROUP \# OT SERV | MA |
| 01 | — | Y65737 | MA BCBS PROV ID \# | MA |