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Individual

CANDACE L JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
3959 BROADWAY, SUITE 106, NEW YORK, NY 10032-1559
(212) 305-6490
(212) 342-5218
Mailing address
622 W 168TH ST, PH4-474, NEW YORK, NY 10032-3720
(212) 305-6490
(212) 342-5218

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
276035
NY
2080P0208X
Pediatric Infectious Diseases Physician
Primary
276035
NY

Other

Enumeration date
06/16/2011
Last updated
03/21/2017
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