Individual
ABIGAIL RUTH JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
5010 STATE HIGHWAY 30 STE 205, AMSTERDAM, NY 12010
(518) 842-2663
(518) 842-4861
Mailing address
5010 STATE HIGHWAY 30 STE 205, AMSTERDAM, NY 12010-7532
(518) 842-2663
(518) 842-4861
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
017834
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
NY
Enumeration date
09/16/2014
Last updated
05/07/2024
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