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General NPI Number Information
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NPI Number | 1225202559
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Entity Type | Organization
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Legal Business Name | DONALD S. JOHNSTON, OD
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Dates
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Enumeration Date | 04/17/2008
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Last Update Date | 04/17/2008
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Provider Practice Location Address
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Address Line | 41 E FRONT ST
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City | RED BANK
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State | NJ
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Zip | 07701-1822
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Country | US
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Telephone | 732-741-0170
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Fax | 732-741-2808
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Provider Business Mailing Address
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Address Line | 41 E FRONT ST
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City | RED BANK
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State | NJ
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Zip | 07701-1822
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Country | US
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Telephone | 732-741-0170
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Fax | 732-741-2808
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Authorized Official
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Title or Position | OWNER
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Name | DR. DONALD SENIOR JOHNSTON
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Credential | OD
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Telephone | 732-741-0170
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 27OA00343400
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License Number State | NJ
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