Individual
DR. TIMOTHY C JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
128 MOTT ST, SUITE 202, NEW YORK, NY 10013-5540
(646) 355-3711
Mailing address
128 MOTT ST, SUITE 202, NEW YORK, NY 10013-5540
(646) 355-3711
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
229556
NY
207RG0100X
Gastroenterology Physician
Primary
229556
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02671901
—
NY
Enumeration date
07/19/2005
Last updated
04/30/2015
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