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Laura Johnson

Specialist in Newark, NY. Individual provider (NPI-1).

NPI number1669922639
StatusActive
Last updated in NPPESOct 13, 2016

Details

NPI
1669922639
Entity type
Individual (NPI-1)
Name
Laura Johnson
Sex
Female
Sole proprietor
Yes
Enumeration date
Oct 13, 2016
Last updated
Oct 13, 2016

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
174400000X Specialist––Yes

Practice location

848 Peirson Ave
Newark, NY 14513-9762

Phone 315-331-2086

Mailing address

848 Peirson Ave
Newark, NY 14513-9762

Phone 315-331-2086

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