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General NPI Number Information
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NPI Number | 1740729128
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Entity Type | Individual
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Provider Name | NADINE JOHNSON RPH
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Gender | Female
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Dates
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Enumeration Date | 02/17/2017
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Last Update Date | 02/17/2017
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Provider Practice Location Address
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Address Line | 23 SLAYTON AVE
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City | SPENCERPORT
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State | NY
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Zip | 14559-1427
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Country | US
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Telephone | 585-352-4020
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Fax | 585-352-4385
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Provider Business Mailing Address
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Address Line | 4120 SAINT PAUL BLVD
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City | ROCHESTER
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State | NY
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Zip | 14617-2351
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Country | US
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Telephone | 203-768-8413
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | I-039375
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 08132
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License Number State | CT
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