Individual
DR. LYNNE LALOR JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
622 W 168TH ST, NEW YORK, NY 10032-3720
(212) 305-6387
Mailing address
630 W 168TH ST, BOX 4, NEW YORK, NY 10032-3725
(212) 342-5155
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
106707
NY
207UN0901X
Nuclear Cardiology Physician
Primary
106707
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00248242
—
NY
Enumeration date
10/17/2006
Last updated
01/07/2015
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