Provider Demographics
NPI:1083877906
Name:MCFARLANE-JOHANSSON, NINA IMASI (MD)
Entity Type:Individual
Prefix:
First Name:NINA
Middle Name:IMASI
Last Name:MCFARLANE-JOHANSSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:282 WASHINGTON STREET
Mailing Address - Street 2:EMERGENCY DEPT. CONNECTICUT CHILDREN'S MEDICAL CENTER
Mailing Address - City:HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06108
Mailing Address - Country:US
Mailing Address - Phone:860-545-9658
Mailing Address - Fax:860-545-8627
Practice Address - Street 1:282 WASHINGTON STREET
Practice Address - Street 2:EMERGENCY DEPT. CONNECTICUT CHILDREN'S MEDICAL CENTER
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06106
Practice Address - Country:US
Practice Address - Phone:860-545-9658
Practice Address - Fax:860-545-8627
Is Sole Proprietor?:No
Enumeration Date:2008-07-10
Last Update Date:2009-07-30
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Provider Licenses
StateLicense IDTaxonomies
NY249431208000000X, 2080P0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0204XAllopathic & Osteopathic PhysiciansPediatricsPediatric Emergency Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics