Individual
DERWIN JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
380 NASSAU RD, ROOSEVELT, NY 11575-1343
(516) 623-7741
(516) 623-7775
Mailing address
10 IRVING PL, ROOSEVELT, NY 11575-2224
(516) 208-8454
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
19272
NY
Other
Enumeration date
09/09/2008
Last updated
12/17/2013
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