Johansson, Jennifer

Johansson, Jennifer is an individual health care provider with primary practice located at 235 Greenfield Pkwy , Liverpool NY 13088-6651. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Dermatology, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is her primary health care specialty. Johansson, Jennifer can be contacted via phone (315) 452-3376.

Contact Information

Primary practice address
235 Greenfield Pkwy Liverpool NY 13088-6651
Phone: (315) 452-3376
Fax: (518) 479-3794
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatology 207N00000X 016039 New York
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 016039 New York

Profile Details

NPI number 1578816856
LBN Legal business name Johansson, Jennifer
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 23rd, 2012
Last updated Nov 15th, 2021 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1578816856 NPPES
New York Other W34181 MEDICARE PTAN
New York Other AA0422 MEDICARE PTAN
New York Other BA0876 MEDICARE PTAN

Popular Providers