MEDICARE: ANTONIA JOHNSON

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1659201630
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANTONIA JOHNSON

Provider Business Mailing Address
First Line	:	700 E 156TH ST APT 18C
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10455-1526
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	745 E 152ND ST APT 13H
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10455-2245
Country	:	US
Telephone Number	:	347-403-3424
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/21/2026
Last Update Date	:	05/21/2026

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Directions to “ ANTONIA JOHNSON ” Practice Location

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