Individual
DR. JENIFER M JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1 THEALL RD, RYE, NY 10580-1404
(914) 848-8700
(914) 848-8701
Mailing address
1 THEALL RD, RYE, NY 10580-1404
(914) 848-8700
(914) 848-8701
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
053095
CT
207Q00000X
Family Medicine Physician
Primary
236084
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02703148
—
NY
01
—
236084-01 CFP
WORKERS COMPENSATION
NY
Enumeration date
01/11/2006
Last updated
07/29/2014
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