Individual
DR. GERALD T. JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
174 STATE HIGHWAY 94, BLAIRSTOWN, NJ 07825
(908) 362-8257
Mailing address
174 ROUTE 94, BLAIRSTOWN, NJ 07825
(908) 362-8257
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OAO003764
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1510908
—
NJ
Enumeration date
01/23/2006
Last updated
07/08/2007
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