Individual
MARIA JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
80 SEYMOUR ST, HARTFORD HOSPITAL MEDICINE DEPT, HARTFORD, CT 06102-5037
(860) 972-2085
Mailing address
80 SEYMOUR ST, HARTFORD, CT 06102-8000
(860) 972-2179
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
004633
CT
363AM0700X
Medical Physician Assistant
Primary
004633
CT
363AS0400X
Surgical Physician Assistant
004633
CT
Other
Enumeration date
08/21/2019
Last updated
12/29/2022
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