Candace L Johnson, M.D.
Pediatrics, Pediatric Infectious Diseases in New York, NY. Individual provider (NPI-1).
NPI number1417242553
StatusActive
Last updated in NPPESMar 21, 2017
Details
- NPI
- 1417242553
- Entity type
- Individual (NPI-1)
- Name
- Candace L Johnson
- Credential
- M.D.
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jun 16, 2011
- Last updated
- Mar 21, 2017
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2080P0208X | Pediatrics, Pediatric Infectious Diseases | 276035 | NY | Yes |
| 208000000X | Pediatrics | 276035 | NY |
Practice location
3959 BroadwaySuite 106
New York, NY 10032-1559
Phone 212-305-6490 · Fax 212-342-5218
Mailing address
622 W 168th StPh4-474
New York, NY 10032-3720
Phone 212-305-6490 · Fax 212-342-5218
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