Individual
SUSAN MARY HART JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
30 HYDE AVE STE 109, VERNON, CT 06066-4503
(860) 454-0303
(860) 875-4242
Mailing address
30 JORDAN LN, WETHERSFIELD, CT 06109-1278
(860) 263-0253
(860) 263-0262
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
000687
CT
Other
Enumeration date
03/13/2007
Last updated
06/25/2021
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