Individual
EDWARD A JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSW
Contact information
Practice address
100 ROUTE 59, AIRMONT, NY 10901-4927
(845) 369-9701
(845) 369-9704
Mailing address
100 ROUTE 59, AIRMONT, NY 10901-4927
(845) 369-9701
(845) 369-9704
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
P69148
NY
Other
Enumeration date
02/08/2010
Last updated
02/08/2010
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