Provider Demographics
NPI:1639394489
Name:DEBRA ANN JOHNSON, INC
Entity Type:Organization
Organization Name:DEBRA ANN JOHNSON, INC
Other - Org Name:DEBRA ANN JOHNSON
Other - Org Type:Doing Business As
Authorized Official - Title/Position:LPN
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:914-762-9363
Mailing Address - Street 1:42 SATINWOOD LN
Mailing Address - Street 2:
Mailing Address - City:BRIARCLIFF MANOR
Mailing Address - State:NY
Mailing Address - Zip Code:10510-2300
Mailing Address - Country:US
Mailing Address - Phone:914-762-9363
Mailing Address - Fax:
Practice Address - Street 1:42 SATINWOOD LN
Practice Address - Street 2:
Practice Address - City:BRIARCLIFF MANOR
Practice Address - State:NY
Practice Address - Zip Code:10510-2300
Practice Address - Country:US
Practice Address - Phone:914-762-9363
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY165506-1251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care