Organization Name: | RUTH A. JOHNSON, M.D. |
NPI Number: | 1578707253 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | WENDY S ESS (OFFICE MANAGER) |
Mailing Address: | 13500 Broadway Alden |
State: | NY US |
Postal Code: | 14004 |
Phone Number: | 7169376743 |
Fax Number: | 7169376453 |
NPI Enumeration Date: | 04/27/2009 |
NPI Last Update Date: | 04/27/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |