Individual
SAMUEL CHARLES-PRABHAKAR JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
1026 46TH ST, BROOKLYN, NY 11219-2401
(917) 682-1875
(718) 435-7908
Mailing address
1026 46TH ST, BROOKLYN, NY 11219-2401
(917) 682-1875
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
62023595
NY
Other
Enumeration date
02/03/2009
Last updated
02/03/2009
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