Individual
SAMANTHA P JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
8620 18TH AVE, BROOKLYN, NY 11214-3702
(718) 256-8818
Mailing address
1000 TARGEE ST APT 3Q, STATEN ISLAND, NY 10304-4466
(330) 390-0840
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
F405201-01
NY
Other
Enumeration date
02/19/2024
Last updated
03/26/2024
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