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General NPI Number Information
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NPI Number | 1962014605
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Entity Type | Individual
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Provider Name | ERICKA JOHNSON
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Gender | Female
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Dates
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Enumeration Date | 08/22/2020
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 22 W 48TH ST STE 300
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City | NEW YORK
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State | NY
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Zip | 10036-1818
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Country | US
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Telephone | 646-837-3661
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1352
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City | NEW YORK
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State | NY
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Zip | 10035-0812
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Country | US
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Telephone | 646-837-3661
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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 | 226300000X
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Taxonomy Name | Kinesiotherapist
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License Number |
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License Number State | NY
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