Individual
EMILY E JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
15 COMMUNITY DR, ADDISON, NY 14801-1140
(607) 359-2291
(607) 359-2294
Mailing address
600 IVY ST STE 206, ELMIRA, NY 14905-1627
(607) 271-2050
(607) 271-2071
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
024215
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05936672
—
NY
05
—
103756780
—
PA
Enumeration date
10/15/2019
Last updated
09/24/2024
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