Organization
JOHNSON & PARK HEALTHY CHOICE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRACEY JOHNSON M.D. (M.D.)
(718) 359-3777
Entity
Organization
Contact information
Practice address
142-25 37TH AVE., #C3, FLUSHING, NY 11354-6530
(718) 359-3777
Mailing address
142-25 37TH AVE., #C3, FLUSHING, NY 11354-6530
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
258418
NY
Other
Enumeration date
01/21/2011
Last updated
01/21/2011
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