Johnson, Detric D

Johnson, Detric D is an individual health care provider with primary practice located at 535 Wyoming Ave Ste 1 , Buffalo NY 14215-3137. She recently has only one registered license in Other Service Providers / Community Health Worker, which is considered as her primary health care specialty. Johnson, Detric D can be contacted via phone (716) 253-1847.

Contact Information

Primary practice address
535 Wyoming Ave Ste 1 Buffalo NY 14215-3137
Phone: (716) 253-1847
Fax: (716) 845-3511
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Community Health Worker 172V00000X New York

Profile Details

NPI number 1568958890
LBN Legal business name Johnson, Detric D
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 10th, 2018
Last updated Jun 6th, 2019 - about 5 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.

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