| Doctor Name: | MR. JAYVINTH JOHNSON |
| NPI Number: | 1013356518 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MS PT |
| License Number: | 036353 |
| Business Practice Address: | 176 Grand St White Plains, NY - 106014803 |
| Business Phone Number: | 9143286080 |
| Business Fax Number: | 9143286081 |
| Mailing Address: | 174 Grand St, WHITE PLAINS |
| State: | NY |
| Postal Code: | 106014803 |
| Phone Number: | 9143288077 |
| Fax Number: | 9143286083 |
| NPI Enumeration Date: | 06/18/2013 |
| NPI Last Update Date: | 10/25/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2251X0800X |
| License Number: | 036353 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | Orthopedic |
| Taxonomy Definition: | |