Individual
DR. GOLDA ODETTE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
910 PARK PL, BROOKLYN, NY 11216-4000
(718) 773-0975
(718) 773-8844
Mailing address
910 PARK PL, BROOKLYN, NY 11216-4000
(718) 773-0975
(718) 773-8844
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
174977
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010022401
MEDICARE RAILROAD
NY
05
—
01076984
—
NY
Enumeration date
11/30/2005
Last updated
06/26/2014
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