Healthcare Provider Details

I. General information

NPI: 1891137550
Provider Name (Legal Business Name): SARAH AUGUSTA JOHNSON MD, FRCPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/23/2013
Last Update Date: 07/23/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1275 YORK AVE DEPARTMENT OF RADIOLOGY
NEW YORK NY
10065-6007
US

IV. Provider business mailing address

425 E 76TH ST APT 2C
NEW YORK NY
10021-2510
US

V. Phone/Fax

Practice location:
  • Phone: 212-639-2267
  • Fax:
Mailing address:
  • Phone: 646-761-9585
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code281P00000X
TaxonomyChronic Disease Hospital
License Number
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: