Individual
ANDREW JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
300 2ND AVE, LONG BRANCH, NJ 07740-6303
(732) 222-5200
Mailing address
68 S SERVICE RD, STE 350, MELVILLE, NY 11747-2354
(516) 945-3357
(516) 945-3131
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
25MB07617400
NJ
207LP2900X
Pain Medicine (Anesthesiology) Physician
25MB07617400
NJ
208VP0014X
Interventional Pain Medicine Physician
25MB07617400
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0146960
—
NJ
01
—
25MB07617400
LICENCE
NJ
Enumeration date
02/28/2006
Last updated
03/07/2023
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