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Individual

DIANA E. JOHANSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
193 LOCUST ST, STE. 2, NORTHAMPTON, MA 01060-2066
(413) 584-8700
(413) 584-1714
Mailing address
193 LOCUST ST, STE. 2, NORTHAMPTON, MA 01060-2066
(413) 584-8700
(413) 584-1714

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
216773
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000026863
BMC
MA
05
0189651
MA
01
04-2817581
UNICARE/GIC
MA
01
216773
CONNECITCARE
MA
01
33435
HEALTH NEW ENGLAND
MA
01
3410756
AETNA
MA
01
467270
TUFTS
MA
01
5306427001
CIGNA
MA
01
AA2007
HARVARD PILGRIM
MA
01
J26513
BCBSMA
MA
Enumeration date
12/29/2005
Last updated
03/15/2012
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