Provider Demographics
NPI:1144591272
Name:POCDIHON, JOHNSON ANABON (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:
First Name:JOHNSON
Middle Name:ANABON
Last Name:POCDIHON
Suffix:
Gender:M
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:218 FALLER DR APT B
Mailing Address - Street 2:
Mailing Address - City:NEW MILFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:07646-5194
Mailing Address - Country:US
Mailing Address - Phone:646-667-7129
Mailing Address - Fax:
Practice Address - Street 1:218 FALLER DR APT B
Practice Address - Street 2:
Practice Address - City:NEW MILFORD
Practice Address - State:NJ
Practice Address - Zip Code:07646-5194
Practice Address - Country:US
Practice Address - Phone:646-667-7129
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-20
Last Update Date:2012-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY033694225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist