Individual
EDWIN JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
528 PROSPECT PL, BROOKLYN, NY 11238-4205
(718) 613-6900
Mailing address
528 PROSPECT PL, BROOKLYN, NY 11238-4205
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86081818
NY
Other
Enumeration date
04/29/2019
Last updated
04/29/2019
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