Provider Demographics
NPI:1417007071
Name:JOHNSON, RYAN P (MD)
Entity Type:Individual
Prefix:DR
First Name:RYAN
Middle Name:P
Last Name:JOHNSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 PLAINSBORO RD
Mailing Address - Street 2:SUITE 460
Mailing Address - City:PLAINSBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:08536-1915
Mailing Address - Country:US
Mailing Address - Phone:609-799-6222
Mailing Address - Fax:609-799-6555
Practice Address - Street 1:5 PLAINSBORO RD
Practice Address - Street 2:SUITE 460
Practice Address - City:PLAINSBORO
Practice Address - State:NJ
Practice Address - Zip Code:08536-1915
Practice Address - Country:US
Practice Address - Phone:609-799-6222
Practice Address - Fax:609-799-6555
Is Sole Proprietor?:No
Enumeration Date:2007-01-12
Last Update Date:2019-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD465289207ND0101X
AZ50409207ND0101X
NJ25MA09453100207ND0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic Surgery