Individual
ELIZA JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BSRT(R), RN, CPNP-PC
Contact information
Practice address
47-01 QUEENS BLVD, #303, QUEENS, NY 11104
(718) 707-3434
Mailing address
245 E 40TH ST APT 18E, NEW YORK, NY 10016-1717
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
383686
NY
363LP2300X
Primary Care Nurse Practitioner
383686
NY
Other
Enumeration date
07/22/2024
Last updated
07/22/2024
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