MEDICARE: JOHNSON NP IN PSYCHIATRY PC

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number	:	1811877160
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JOHNSON NP IN PSYCHIATRY PC

Provider Business Mailing Address
First Line	:	7 FOX HILL RD
Second Line	:
City	:	ALBRIGHTSVILLE
State	:	PA
Zip	:	18210-3837
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3380 NOSTRAND AVENUE
Second Line	:	STE 1E
City	:	BROOKLYN
State	:	NY
Zip	:	11229
Country	:	US
Telephone Number	:	917-268-0881
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	DAVID JOHNSON
Credential	:	PMHNP-BC
Telephone Number	:	917-268-0881

Provider Enumeration Date	:	09/06/2025
Last Update Date	:	12/08/2025

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