Individual
MRS. JOHANNA LAINE D'ADDARIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
20 YORK ST, NEW HAVEN, CT 06510-3220
(203) 688-2615
Mailing address
24 TIMBERLINE DR, FARMINGTON, CT 06032-1744
(212) 920-1857
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
—
—
363AM0700X
Medical Physician Assistant
Primary
2578
CT
Other
Enumeration date
12/15/2008
Last updated
12/07/2022
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