Most Relevant Information
Provider Data
| NPI Number: | 1003501453 |
| Provider Name: | JOSHUA AUSTIN JOHNSON |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: |
Most Important Dates
| Enumeration Date: | 04/10/2023 |
| Last Updated: | 04/10/2023 |
Provider Practice Location
301 PROSPECT AVE
SYRACUSE
NY
132031899
Practice Location Phone/Fax
| Phone: | 3154485111 |
| Fax: | 3154486313 |
Provider Mailing Location
301 PROSPECT AVE
SYRACUSE
NY
132031899
Provider Mailing Phone/Fax
| Phone: | 3154485111 |
| Fax: | 3154486313 |