Individual
ANGELICA JOHNSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3400 SPRUCE ST, PHILADELPHIA, PA 19104-4238
(215) 615-3564
Mailing address
3400 SPRUCE ST, PHILADELPHIA, PA 19104-4238
(215) 615-3564
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
332650
NY
207Q00000X
Family Medicine Physician
Primary
MD493653
PA
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
02/21/2023
Last updated
06/04/2026
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