Provider Demographics
NPI:1235679382
Name:JOHNSON, BENJAMIN V SR (CPBT)
Entity Type:Individual
Prefix:MR
First Name:BENJAMIN
Middle Name:V
Last Name:JOHNSON
Suffix:SR
Gender:M
Credentials:CPBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 CROSSINGS BLVD
Mailing Address - Street 2:SUITE 227
Mailing Address - City:ELVERSON
Mailing Address - State:PA
Mailing Address - Zip Code:19520-9070
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:210 CROSSINGS BLVD
Practice Address - Street 2:SUITE 227
Practice Address - City:ELVERSON
Practice Address - State:PA
Practice Address - Zip Code:19520-9070
Practice Address - Country:US
Practice Address - Phone:484-319-9235
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-07
Last Update Date:2017-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy