Provider Demographics
NPI:1225202559
Name:DONALD S. JOHNSTON, OD
Entity Type:Organization
Organization Name:DONALD S. JOHNSTON, OD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:SENIOR
Authorized Official - Last Name:JOHNSTON
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:732-741-0170
Mailing Address - Street 1:41 E FRONT ST
Mailing Address - Street 2:
Mailing Address - City:RED BANK
Mailing Address - State:NJ
Mailing Address - Zip Code:07701-1822
Mailing Address - Country:US
Mailing Address - Phone:732-741-0170
Mailing Address - Fax:732-741-2808
Practice Address - Street 1:41 E FRONT ST
Practice Address - Street 2:
Practice Address - City:RED BANK
Practice Address - State:NJ
Practice Address - Zip Code:07701-1822
Practice Address - Country:US
Practice Address - Phone:732-741-0170
Practice Address - Fax:732-741-2808
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-17
Last Update Date:2008-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ27OA00343400152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0353670001OtherDME