Individual
CAROL JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
706 MARTHA ST, ELMONT, NY 11003-4328
(646) 821-4444
Mailing address
706 MARTHA ST, ELMONT, NY 11003-4328
(646) 821-4444
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
286562
NY
Other
Enumeration date
11/06/2008
Last updated
11/06/2008
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