| Doctor Name: | JALIL ABDUL JOHNSON |
| NPI Number: | 1003121351 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | NP |
| License Number: | 270185 |
| Business Practice Address: | 140 High St Springfield, MA - 011051442 |
| Business Phone Number: | 4137942511 |
| Business Fax Number: | 4137948428 |
| Mailing Address: | 280 Chestnut St, 2nd Floor SPRINGFIELD |
| State: | MA |
| Postal Code: | 011991001 |
| Phone Number: | 4137945700 |
| Fax Number: | |
| NPI Enumeration Date: | 08/11/2010 |
| NPI Last Update Date: | 05/19/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LA2200X |
| License Number: | 270185 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Adult Health |
| Taxonomy Definition: | |