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General NPI Number Information
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NPI Number | 1073694022
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Entity Type | Individual
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Provider Name | CARYL D JOHNSON OT CHT
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Gender | Female
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Dates
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Enumeration Date | 10/18/2006
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Last Update Date | 12/08/2011
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Provider Practice Location Address
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Address Line | 160 W 66TH ST SUITE 37-J
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City | NEW YORK
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State | NY
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Zip | 10023-6555
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Country | US
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Telephone | 212-721-0460
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Fax | 646-559-2792
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Provider Business Mailing Address
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Address Line | PO BOX 237046 ANSONIA STATION
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City | NEW YORK
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State | NY
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Zip | 10023-0028
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Country | US
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Telephone | 212-721-0460
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Fax | 646-559-2792
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 0033341
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License Number State | NY
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