Individual
MRS. SUMAN P JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHYSICIAN ASSITANT
Contact information
Practice address
259 1ST ST, MINEOLA, NY 11501-3957
(516) 663-8312
Mailing address
27005 76TH AVE, NEW HYDE PARK, NY 11040-1402
(516) 470-7000
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
015591-1
NY
Other
Enumeration date
07/19/2012
Last updated
08/29/2022
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