Individual
PHILIP THOMAS JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
20 YORK ST, NEW HAVEN, CT 06510-3220
(203) 688-6963
Mailing address
360 STATE ST, APT. 2608, NEW HAVEN, CT 06510-3601
(310) 902-7247
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
3293
CA
367500000X
Certified Registered Nurse Anesthetist
Primary
4055
CT
367500000X
Certified Registered Nurse Anesthetist
ARNP9298728
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1048135
—
LA
05
—
RN4326530
—
CA
Enumeration date
06/12/2006
Last updated
04/14/2016
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