Johnson, Shereka A

Johnson, Shereka A is an sole proprietor health care provider with primary practice located at 15 Matthews St , Goshen NY 10924-1995. She recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Licensed Practical Nurse, Physician Assistants & Advanced Practice Nursing Providers / Adult Health. Physician Assistants & Advanced Practice Nursing Providers / Adult Health is her primary health care specialty. Johnson, Shereka A can be contacted via phone (347) 393-6500.

Contact Information

Primary practice address
15 Matthews St Goshen NY 10924-1995
Phone: (347) 393-6500
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Licensed Practical Nurse 164W00000X 298220 New York
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 363LA2200X F310116-01 New York

Profile Details

NPI number 1558665018
LBN Legal business name Johnson, Shereka A
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 27th, 2010
Last updated Feb 9th, 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1558665018 NPPES
New York MEDICAID NY

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