Individual
CHARLES JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
949 COLUMBIA ST, HUDSON, NY 12534-2624
(518) 828-7188
(518) 828-5049
Mailing address
949 COLUMBIA ST, HUDSON, NY 12534-2624
(518) 828-7188
(518) 828-5049
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
217292
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02103244
—
NY
Enumeration date
09/20/2006
Last updated
12/17/2007
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