Individual
JUDITH A JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
300 2ND AVE, LONG BRANCH, NJ 07740-6303
(732) 225-2000
Mailing address
3998 FAIR RIDGE DRIVE, SUITE 300, FAIRFAX, VA 22033-2921
(703) 295-9360
(703) 766-9725
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
25MA06098800
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6367208
—
NJ
01
—
P00740081
RAILROAD MEDICARE
NJ
Enumeration date
11/07/2006
Last updated
04/03/2015
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