Provider Demographics
NPI:1871731141
Name:MUSI, LONI ANN (DDS)
Entity type:Individual
Prefix:DR
First Name:LONI
Middle Name:ANN
Last Name:MUSI
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:LONI
Other - Middle Name:ANN
Other - Last Name:RODRIGUEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:594 EAST MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10940
Mailing Address - Country:US
Mailing Address - Phone:845-342-2125
Mailing Address - Fax:845-342-1727
Practice Address - Street 1:594 EAST MAIN STREET
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:NY
Practice Address - Zip Code:10940
Practice Address - Country:US
Practice Address - Phone:845-342-2125
Practice Address - Fax:845-342-1727
Is Sole Proprietor?:No
Enumeration Date:2009-01-26
Last Update Date:2016-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0544501223G0001X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT010196Medicaid