Individual
ARCHIEBOLD JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
111 E 210TH ST, BRONX, NY 10467-2401
(718) 920-4316
(718) 881-2245
Mailing address
111 E 210TH ST, BRONX, NY 10467-2401
(718) 881-2245
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
304245
NY
Other
Enumeration date
03/28/2016
Last updated
11/30/2020
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