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General NPI Number Information
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NPI Number | 1164342853
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Entity Type | Individual
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Provider Name | SHEREIKA JOHNSON
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Gender | Female
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Dates
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Enumeration Date | 07/21/2026
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Last Update Date | 07/21/2026
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Provider Practice Location Address
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Address Line | 7905 MAIN RD
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City | MATTITUCK
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State | NY
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Zip | 11952-1693
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Country | US
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Telephone | 631-298-2030
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Fax |
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Provider Business Mailing Address
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Address Line | 440 MARCY AVE
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City | RIVERHEAD
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State | NY
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Zip | 11901-2911
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Country | US
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Telephone | 901-474-9076
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | F358784
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License Number State | NY
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