Individual
ISHMAEL JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
142 GRIGGS ST, WATERBURY, CT 06704-3110
(203) 574-1419
Mailing address
141 E MAIN ST, WATERBURY, CT 06702-2310
(203) 574-9000
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
06/12/2023
Last updated
06/12/2023
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