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General NPI Number Information
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NPI Number | 1083910053
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Entity Type | Individual
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Provider Name | DANA ANNE JOHNSTON MS, ATC
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Gender | Female
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Dates
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Enumeration Date | 02/08/2011
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Last Update Date | 02/08/2011
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Provider Practice Location Address
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Address Line | 35 N SHORE RD
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City | PUTNAM VALLEY
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State | NY
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Zip | 10579-1521
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Country | US
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Telephone | 845-661-5838
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Fax | 845-938-6297
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Provider Business Mailing Address
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Address Line | 35 N SHORE RD
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City | PUTNAM VALLEY
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State | NY
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Zip | 10579-1521
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Country | US
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Telephone | 845-661-5838
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Fax | 845-938-6297
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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 | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 001985-1
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License Number State | NY
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