Individual
MISS CAROL M JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
545 E 142ND ST, BRONX, NY 10454-2110
(718) 240-0513
Mailing address
17505 139TH RD, JAMAICA, NY 11434-4535
(646) 334-7600
(718) 206-1289
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
F332519
NY
Other
Enumeration date
05/29/2007
Last updated
12/06/2024
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