Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 249431 | NY |
Y | 2080P0204X | Pediatric Emergency Doctor | 249431 | NY |
NPI | 1083877906 |
---|---|
Provider Name | Nina Imasi Mcfarlane-Johansson |
First Address | Hartford, CT 06108 |
Second Address | Hartford, CT 06106 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/07/2008 |
Last Update Date | 30/07/2009 |