Individual
MR. HENRY SISUN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.S.P.T.
Contact information
Practice address
721 RESERVOIR AVE, CRANSTON, RI 02910-4430
(401) 946-4250
(401) 942-3960
Mailing address
721 RESERVOIR AVE, CRANSTON, RI 02910-4430
(401) 946-4250
(401) 942-3960
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
5669
MA
225100000X
Physical Therapist
Primary
PT00646
RI
Other
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
Enumeration date
11/09/2005
Last updated
09/27/2011
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us