Provider Demographics
NPI:1780774414
Name:COHN-HAFT, HERA MARIA JOHNSTON (MD)
Entity type:Individual
Prefix:DR
First Name:HERA
Middle Name:MARIA JOHNSTON
Last Name:COHN-HAFT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:805 FARMINGTON AVE
Mailing Address - Street 2:SUITE 212
Mailing Address - City:WEST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06119-1670
Mailing Address - Country:US
Mailing Address - Phone:860-521-5575
Mailing Address - Fax:860-521-5575
Practice Address - Street 1:10 N MAIN ST
Practice Address - Street 2:SUITE 212
Practice Address - City:WEST HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06107-1968
Practice Address - Country:US
Practice Address - Phone:860-521-5575
Practice Address - Fax:860-521-5575
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-13
Last Update Date:2016-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0256742084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT260004389Medicare ID - Type Unspecified
CTB83535Medicare UPIN