Individual
ALTHEA JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
674 COLFAX PL, VALLEY STREAM, NY 11581-3006
(516) 295-2525
Mailing address
674 COLFAX PL, VALLEY STREAM, NY 11581-3006
(516) 295-2525
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
09/26/2012
Last updated
09/26/2012
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