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1770240152
KEVIN JOHNSON
MINEOLA, NY
NPI
1770240152
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: NY 027051)
Enumeration Date
2021-11-20
Last Update Date
2021-11-20
Business Address
KEVIN JOHNSON
259 1ST ST
MINEOLA, NY 11501-3957
Phone number: 516-663-0333
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Mailing Address
KEVIN JOHNSON
259 1ST ST
MINEOLA, NY 11501-3957
Phone number: 516-663-0333
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