Healthcare Provider Details

I. General information

NPI: 1780885871
Provider Name (Legal Business Name): LINDSAY CALLAHAN JOHNSTON MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/29/2007
Last Update Date: 06/23/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 CEDAR ST, WP 493 BOX 208064, YALE UNIVERSITY, DEPT. OF PEDIATRICS, NEONATOLOGY
NEW HAVEN CT
06520-8064
US

IV. Provider business mailing address

PO BOX 208064, 333 CEDAR ST, WP 493 YALE UNIVERSITY, DEPT. OF PEDIATRICS, NEONATOLOGY
NEW HAVEN CT
06520-8064
US

V. Phone/Fax

Practice location:
  • Phone: 203-688-2320
  • Fax: 203-688-5426
Mailing address:
  • Phone: 203-688-2320
  • Fax: 203-688-5426

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD428336
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License NumberMD428336
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: