Individual
MRS. VINCY MARIA JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGACNP
Contact information
Practice address
301 E MAIN ST, BAY SHORE, NY 11706-8458
(631) 968-3000
(631) 968-3813
Mailing address
301 E MAIN ST, BAY SHORE, NY 11706-8458
(631) 968-3000
(631) 968-3813
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
F431550-01
NY
363LA2100X
Acute Care Nurse Practitioner
F431550-01
NJ
363LA2100X
Acute Care Nurse Practitioner
F431550-01
NY
Other
Enumeration date
07/24/2019
Last updated
07/24/2019
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