Individual
MR. NATHANIEL PAUL JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1450 CHAPEL ST, NEW HAVEN, CT 06511-4405
(203) 789-3000
Mailing address
30 HAZEL ST, BRIDGEPORT, CT 06604-7752
(203) 576-2400
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
06/22/2024
Last updated
06/22/2024
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