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General NPI Number Information
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NPI Number | 1689456071
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Entity Type | Individual
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Provider Name | ELIZABETH EVA JOHNSTON
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Gender | Female
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Dates
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Enumeration Date | 10/19/2023
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Last Update Date | 10/19/2023
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Provider Practice Location Address
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Address Line | 825 7TH AVE FL 6
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City | NEW YORK
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State | NY
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Zip | 10019-6014
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Country | US
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Telephone | 332-259-5621
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Fax |
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Provider Business Mailing Address
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Address Line | 811 FOSTER AVE
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City | BROOKLYN
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State | NY
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Zip | 11230-1358
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Country | US
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Telephone | 917-992-0328
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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