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Individual

DANNY JOHNSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
196 SHAKER RD, ALBANY, NY 12211-2028
(443) 935-8076
Mailing address
196 SHAKER RD, ALBANY, NY 12211-2028
(443) 935-8076

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
6519519
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
6519519
LLC
NY
Enumeration date
10/11/2022
Last updated
10/11/2022
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