Individual
MR. NILES SAMUEL JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
566 7TH AVE FL 4, NEW YORK, NY 10018-1802
(212) 564-7631
(212) 564-7819
Mailing address
566 7TH AVE FL 4, NEW YORK, NY 10018-1802
(212) 564-7631
(212) 564-7819
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
NY
Other
Enumeration date
11/01/2024
Last updated
11/12/2025
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