Provider Demographics
NPI:1346348745
Name:JOHNSON, MONICA J (NP, LAC, DC)
Entity Type:Individual
Prefix:DR
First Name:MONICA
Middle Name:J
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:NP, LAC, DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1362 MORRIS AVE
Mailing Address - Street 2:
Mailing Address - City:UNION
Mailing Address - State:NJ
Mailing Address - Zip Code:07083-3342
Mailing Address - Country:US
Mailing Address - Phone:908-755-0200
Mailing Address - Fax:908-603-8343
Practice Address - Street 1:1362 MORRIS AVE
Practice Address - Street 2:
Practice Address - City:UNION
Practice Address - State:NJ
Practice Address - Zip Code:07083
Practice Address - Country:US
Practice Address - Phone:908-755-0200
Practice Address - Fax:908-603-8343
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2022-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00504900111N00000X
NJ25MZ00020100171100000X
NJ26NJ0062900363LG0600X
NJ26NJ00629000363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No111N00000XChiropractic ProvidersChiropractor
No171100000XOther Service ProvidersAcupuncturist
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJP00699500OtherCDS REGISTRATION
NJP00699500OtherCDS