Individual
DAVID HUGO JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NPC
Contact information
Practice address
3505 VETERANS MEMORIAL HWY, RONKONKOMA, NY 11779
(631) 676-7656
(631) 676-7648
Mailing address
3505 VETERANS MEMORIAL HWY, RONKONKOMA, NY 11779
(631) 676-7656
(631) 676-7648
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
F3036431
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
F3036431
UNIVERSITY STATE NY OFFIC
NY
Enumeration date
09/06/2006
Last updated
03/07/2023
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