Healthcare Provider Details

I. General information

NPI: 1952656639
Provider Name (Legal Business Name): CHRISTA MARIE JOHNSON AU.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/18/2012
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 HOWARD AVE FL 4
NEW HAVEN CT
06519-1369
US

IV. Provider business mailing address

800 HOWARD AVE FL 4
NEW HAVEN CT
06519-1369
US

V. Phone/Fax

Practice location:
  • Phone: 203-785-5430
  • Fax:
Mailing address:
  • Phone: 203-785-5430
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number728
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number2423
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: