Individual
KATHLEEN JOHANSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.O
Contact information
Practice address
905 STOCKTON RD, VALLEY COTTAGE, NY 10989-2637
(845) 641-8753
Mailing address
905 STOCKTON RD, VALLEY COTTAGE, NY 10989-2637
(845) 641-8753
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
294456
NY
Other
Enumeration date
03/29/2012
Last updated
04/23/2019
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