Provider Demographics
NPI:1568730315
Name:JOHNSON-SALMON, NARDA (SPECIAL EDUCATION MS)
Entity Type:Individual
Prefix:
First Name:NARDA
Middle Name:
Last Name:JOHNSON-SALMON
Suffix:
Gender:F
Credentials:SPECIAL EDUCATION MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1436 EAST 59TH STREET
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11234
Mailing Address - Country:US
Mailing Address - Phone:718-968-2987
Mailing Address - Fax:
Practice Address - Street 1:1436 E 59TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11234-4126
Practice Address - Country:US
Practice Address - Phone:718-968-2987
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-08
Last Update Date:2011-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1658589174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist