Individual provider · NPI-1

Vincent Gregory Johnson, D.O.

· Babylon, NY

NPI number1447363312
StatusActive
Last updated in NPPESOct 14, 2022

Details

NPI
1447363312
Entity type
Individual (NPI-1)
Name
Vincent Gregory Johnson
Credential
D.O.
Sex
Male
Sole proprietor
No
Enumeration date
Aug 16, 2006
Certification date
Oct 14, 2022
Last updated
Oct 14, 2022

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
208VP0000X 291245NYYes
207LP2900X Anesthesiology, Pain Medicine100207MO
207LP2900X Anesthesiology, Pain Medicine291245NY

Practice location

500 W Main St Ste 116
Babylon, NY 11702-3032

Phone 631-422-6166 · Fax 631-622-6266

Mailing address

Po Box 10668
Albany, NY 12201-5668

Phone 866-987-3990 · Fax 877-308-9097

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