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General NPI Number Information
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NPI Number | 1124361027
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Entity Type | Individual
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Provider Name | MR. WILLIAM THOMAS JOHNSON
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Gender | Male
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Dates
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Enumeration Date | 03/29/2013
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Last Update Date | 06/19/2020
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Provider Practice Location Address
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Address Line | 1275 YORK AVE
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City | NEW YORK
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State | NY
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Zip | 10065-6007
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Country | US
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Telephone | 646-227-3764
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Fax |
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Provider Business Mailing Address
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Address Line | 100 E LANCASTER AVE
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City | WYNNEWOOD
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State | PA
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Zip | 19096-3450
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Country | US
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Telephone | 814-591-3303
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Fax |
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | 305245
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License Number State | NY
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