Individual
AUSTIN JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRPA
Contact information
Practice address
45 AVON PL APT 2A, STATEN ISLAND, NY 10301-3135
(347) 865-2896
Mailing address
45 AVON PL APT 2A, STATEN ISLAND, NY 10301-3135
(347) 865-2896
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
CRPA-P-7473
NY
Other
Enumeration date
04/29/2024
Last updated
04/29/2024
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