Individual
MICHAEL JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
ELM AND CARLTON STREETS, BUFFALO, NY 14263-0001
(716) 845-2300
Mailing address
89 PUTNAM ST, BUFFALO, NY 14213-1651
(716) 866-0759
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
309020
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
309020
NYS LICENSE
NY
Enumeration date
12/20/2018
Last updated
01/19/2021
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