Provider Demographics
NPI:1801026323
Name:ROBERT WOOD JOHSNON
Entity Type:Organization
Organization Name:ROBERT WOOD JOHSNON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BETH-ANN
Authorized Official - Middle Name:
Authorized Official - Last Name:SHANKER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:215-677-0726
Mailing Address - Street 1:1 RICHMOND ST
Mailing Address - Street 2:
Mailing Address - City:NEW BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08901-4100
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1 RICHMOND ST
Practice Address - Street 2:
Practice Address - City:NEW BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08901-4100
Practice Address - Country:US
Practice Address - Phone:215-677-0726
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-17
Last Update Date:2009-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital