Provider Demographics
NPI:1730113689
Name:FIGUEROA, JOHANNA C (MD)
Entity Type:Individual
Prefix:
First Name:JOHANNA
Middle Name:C
Last Name:FIGUEROA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:216 WILLIS AVE
Mailing Address - Street 2:SUITE 001
Mailing Address - City:ROSLYN HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11577
Mailing Address - Country:US
Mailing Address - Phone:516-399-2501
Mailing Address - Fax:516-399-2504
Practice Address - Street 1:216 WILLIS AVE
Practice Address - Street 2:SUITE 001
Practice Address - City:ROSLYN HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11577-2125
Practice Address - Country:US
Practice Address - Phone:516-399-2501
Practice Address - Fax:516-399-2504
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2018-03-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY212108208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY181097POtherHIP
NY02646371Medicaid
NY2398359OtherUHC
I12901Medicare UPIN
NY36R581Medicare PIN