Provider Demographics
NPI:1417537648
Name:GAYE, JOHNSON GBENPLAY
Entity Type:Individual
Prefix:MR
First Name:JOHNSON
Middle Name:GBENPLAY
Last Name:GAYE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3908 BUSH CT
Mailing Address - Street 2:
Mailing Address - City:ABINGDON
Mailing Address - State:MD
Mailing Address - Zip Code:21009-1193
Mailing Address - Country:US
Mailing Address - Phone:610-931-2442
Mailing Address - Fax:
Practice Address - Street 1:3908 BUSH CT
Practice Address - Street 2:
Practice Address - City:ABINGDON
Practice Address - State:MD
Practice Address - Zip Code:21009-1193
Practice Address - Country:US
Practice Address - Phone:610-931-2442
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-12
Last Update Date:2021-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR078592471C3402X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2471C3402XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistRadiography