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1073890729
JOHNSON EXANTUS
DEER PARK, NY
NPI
1073890729
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
164W00000X Licensed Practical Nurse
(Licence: NY 301511)
Enumeration Date
2011-11-09
Last Update Date
2011-11-09
Business Address
-- JOHNSON EXANTUS LPN
60 CROWN ST
DEER PARK, NY 11729-6921
Phone number: 631-392-0199
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Mailing Address
-- JOHNSON EXANTUS LPN
60 CROWN ST
DEER PARK, NY 11729-6921
Phone number: 631-392-0199
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