Johnson, Eric Robert

Johnson, Eric Robert is an individual health care provider with primary practice located at 59 West Ave , Brockport NY 14420. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Johnson, Eric Robert can be contacted via phone (585) 637-6120.

Contact Information

Primary practice address
59 West Ave Brockport NY 14420
Phone: (585) 637-6120
Fax: (585) 637-4772
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 180005 New York

Profile Details

NPI number 1770546277
LBN Legal business name Johnson, Eric Robert
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 7th, 2006
Last updated Jul 8th, 2007 - about 17 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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Identifiers

StateTypeNumberIssuer
All States NPI 1770546277 NPPES
New York MEDICAID 01414933

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