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General NPI Number Information
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NPI Number | 1285261057
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Entity Type | Individual
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Provider Name | ULYSSES JOHNSON III
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Gender | Male
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Dates
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Enumeration Date | 03/23/2020
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Last Update Date | 09/15/2025
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Provider Practice Location Address
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Address Line | 1000 10TH AVE
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City | NEW YORK
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State | NY
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Zip | 10019-1147
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Country | US
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Telephone | 212-523-6121
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 28082
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City | NEW YORK
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State | NY
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Zip | 10087-5024
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Country | US
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Telephone | 800-627-4470
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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 | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 131243
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN702922
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License Number State | PA
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