Individual
ROBERT JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
90 BERGEN ST, SUITE 4300, NEWARK, NJ 07103-2425
(973) 972-2100
Mailing address
30 BERGEN ST, ADMC 12 1205, NEWARK, NJ 07107-3000
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
25MA02744100
NJ
2080A0000X
Pediatric Adolescent Medicine Physician
118888-1
NY
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
25MA02744100
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03824935
—
NY
05
—
0853909
—
NJ
Enumeration date
07/20/2006
Last updated
01/24/2022
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