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General NPI Number Information
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NPI Number | 1356963755
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Entity Type | Organization
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Legal Business Name | BRANDON B JOHNSON MD PC
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Dates
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Enumeration Date | 05/08/2020
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Last Update Date | 07/22/2021
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Provider Practice Location Address
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Address Line | 161 E 32ND ST
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City | NEW YORK
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State | NY
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Zip | 10016-6002
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Country | US
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Telephone | 212-979-2020
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Fax | 267-421-4838
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Provider Business Mailing Address
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Address Line | 161 E 32ND ST
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City | NEW YORK
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State | NY
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Zip | 10016-6002
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Country | US
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Telephone | 917-284-6999
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Fax | 917-551-5795
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Authorized Official
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Title or Position | PRACTICE OWNER
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Name | BRANDON B JOHNSON
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Credential | MD
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Telephone | 917-284-6999
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207WX0107X
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Taxonomy Name | Retina Specialist (Ophthalmology) Physician
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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 | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number |
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License Number State |
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