Individual
JOANNA ANTONINA GIBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD, PHD
Contact information
Practice address
20 YORK ST, DEPARTMENT OF PATHOLOGY EP2-610, NEW HAVEN, CT 06510-3220
(203) 737-6832
Mailing address
20 YORK ST, DEPARTMENT OF PATHOLOGY EP2-610, NEW HAVEN, CT 06510-3220
(203) 737-6832
Taxonomy
Speciality
Code
Description
License number
State
207ZP0101X
Anatomic Pathology Physician
Primary
050172
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ENROLLED
—
MN
01
—
P00771165
MEDICARE RAILROAD
MN
Enumeration date
11/15/2006
Last updated
03/26/2013
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