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Individual

CHARYSSE JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
1030 BOULEVARD, WEST HARTFORD, CT 06119-1801
(860) 986-6440
Mailing address
18 TOWNLEY ST APT H3, HARTFORD, CT 06105-1864
(917) 302-5899

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
3209
CT

Other

Enumeration date
10/17/2014
Last updated
03/31/2016
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