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General NPI Number Information
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NPI Number | 1174502918
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Entity Type | Individual
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Provider Name | JENIFER M JOHNSON MD
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Gender | Female
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Dates
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Enumeration Date | 01/11/2006
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Last Update Date | 07/29/2014
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Provider Practice Location Address
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Address Line | 1 THEALL RD
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City | RYE
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State | NY
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Zip | 10580-1404
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Country | US
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Telephone | 914-848-8700
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Fax | 914-848-8701
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Provider Business Mailing Address
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Address Line | 1 THEALL RD
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City | RYE
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State | NY
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Zip | 10580-1404
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Country | US
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Telephone | 914-848-8700
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Fax | 914-848-8701
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 236084
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 053095
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License Number State | CT
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