Provider Demographics
NPI:1578707253
Name:RUTH A. JOHNSON, M.D.
Entity Type:Organization
Organization Name:RUTH A. JOHNSON, M.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:WENDY
Authorized Official - Middle Name:S
Authorized Official - Last Name:ESS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:716-937-6743
Mailing Address - Street 1:13500 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:ALDEN
Mailing Address - State:NY
Mailing Address - Zip Code:14004
Mailing Address - Country:US
Mailing Address - Phone:716-937-6743
Mailing Address - Fax:716-937-6453
Practice Address - Street 1:13500 BROADWAY
Practice Address - Street 2:
Practice Address - City:ALDEN
Practice Address - State:NY
Practice Address - Zip Code:14004
Practice Address - Country:US
Practice Address - Phone:716-937-6743
Practice Address - Fax:716-937-6453
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RUTH A. JOHNSON, M.D.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-04-27
Last Update Date:2009-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty