Individual
MRS. AMANDA JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
85 BARTLETT ST, BROOKLYN, NY 11206-4429
(718) 387-8181
Mailing address
107 N EMERSON AVE, COPIAGUE, NY 11726-3116
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
316370-1
NY
Other
Enumeration date
05/15/2014
Last updated
05/15/2014
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