Provider Demographics
NPI:1770477382
Name:JOHNSON, TONYA LORRAINE (PHARMD)
Entity type:Individual
Prefix:
First Name:TONYA
Middle Name:LORRAINE
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:TONYA
Other - Middle Name:LORRAINE
Other - Last Name:WELLS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:409 RAMAPO VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:NJ
Mailing Address - Zip Code:07436-2707
Mailing Address - Country:US
Mailing Address - Phone:201-337-2349
Mailing Address - Fax:
Practice Address - Street 1:409 RAMAPO VALLEY RD
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:NJ
Practice Address - Zip Code:07436-2707
Practice Address - Country:US
Practice Address - Phone:201-337-2349
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-06
Last Update Date:2025-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI01832600183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist