Individual
VINCENT GREGORY JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
500 W MAIN ST STE 116, BABYLON, NY 11702-3032
(631) 422-6166
(631) 622-6266
Mailing address
PO BOX 10668, ALBANY, NY 12201-5668
(866) 987-3990
(877) 308-9097
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
100207
MO
207LP2900X
Pain Medicine (Anesthesiology) Physician
291245
NY
208VP0000X
Pain Medicine Physician
Primary
291245
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
18469031
BCBS OF KANSAS CITY
MO
05
—
200007670B
—
KS
05
—
243881604
—
MO
Enumeration date
08/16/2006
Last updated
10/14/2022
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