Organization
JOHNSON MEDICAL SPECIALISTS, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES BIZILJ MD (PRESIDENT)
(860) 684-8125
Entity
Organization
Contact information
Practice address
201 CHESTNUT HILL RD, ATTN: LORI LADUE, STAFFORD SPRINGS, CT 06076-4005
(860) 684-8415
Mailing address
201 CHESTNUT HILL RD, STAFFORD SPRINGS, CT 06076-4005
(860) 684-8415
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
D100000258
MEDICARE PTAN
CT
Enumeration date
06/02/2009
Last updated
12/01/2009
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