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General NPI Number Information
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NPI Number | 1740314061
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Entity Type | Organization
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Legal Business Name | JOHNSON OCCUPATIONAL MEDICINE CENTER
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Dates
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Enumeration Date | 03/16/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3 WEYMOUTH RD
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City | ENFIELD
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State | CT
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Zip | 06083-1153
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Country | US
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Telephone | 860-763-7668
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Fax | 860-763-7676
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Provider Business Mailing Address
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Address Line | PO BOX 1153 3 WEYMOUTH ROAD
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City | ENFIELD
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State | CT
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Zip | 06083-1153
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Country | US
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Telephone | 860-763-7668
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Fax | 860-763-7676
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. MICHAEL ERDIL
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Credential | M.D.
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Telephone | 860-763-7668
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QX0100X
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Taxonomy Name | Occupational Medicine Clinic/Center
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License Number |
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License Number State |
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