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General NPI Number Information
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NPI Number | 1467101352
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Entity Type | Individual
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Provider Name | DENNIS OWUSU
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Gender | Male
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Dates
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Enumeration Date | 03/20/2022
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Last Update Date | 03/20/2022
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Provider Practice Location Address
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Address Line | 40 DEERFIELD CT APT D
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City | EAST HARTFORD
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State | CT
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Zip | 06108-4711
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Country | US
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Telephone | 860-890-5112
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 280902
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City | EAST HARTFORD
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State | CT
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Zip | 06128-0902
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Country | US
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Telephone | 860-890-5112
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 376J00000X
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Taxonomy Name | Homemaker
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License Number | 0002004
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License Number State | CT
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