Provider Demographics
NPI:1619105970
Name:JOHNSON, LINDA TRENKA (MD)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:TRENKA
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:LINDA
Other - Middle Name:KATHERINE
Other - Last Name:TRENKA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:4 CLARK COURT
Mailing Address - Street 2:
Mailing Address - City:EAST WINDSOR
Mailing Address - State:NJ
Mailing Address - Zip Code:08520-2720
Mailing Address - Country:US
Mailing Address - Phone:609-448-2751
Mailing Address - Fax:
Practice Address - Street 1:4 CLARK COURT
Practice Address - Street 2:
Practice Address - City:EAST WINDSOR
Practice Address - State:NJ
Practice Address - Zip Code:08520-2720
Practice Address - Country:US
Practice Address - Phone:609-448-2751
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-25
Last Update Date:2009-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA03398800207Q00000X
PAMD030640E207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine