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Individual

DR. JENNIFER MARIA JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD, PHD

Contact information

Practice address
925 CHESTNUT ST, SUITE 320A, PHILADELPHIA, PA 19107-4216
(215) 955-8874
(215) 955-2340
Mailing address
925 CHESTNUT ST, SUITE 320A, PHILADELPHIA, PA 19107-4216
(215) 955-8874
(215) 955-2340

Taxonomy

Speciality
Code
Description
License number
State
207RX0202X
Medical Oncology Physician
25MA1055100
NJ
207RX0202X
Medical Oncology Physician
Primary
MD443712
PA
390200000X
Student in an Organized Health Care Education/Training Program
MT193621
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0476374
NJ
05
103041968
PA
Enumeration date
06/16/2008
Last updated
01/03/2019
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