Johnson, Vincent Gregory
Johnson, Vincent Gregory is an individual health care provider with primary practice located at 500 W Main St Ste 116 , Babylon NY 11702-3032. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pain Medicine, which is considered as his primary health care specialty. Johnson, Vincent Gregory can be contacted via phone (631) 422-6166.Contact Information
Primary practice address
500 W Main St Ste 116
Babylon NY 11702-3032
Phone: (631) 422-6166
Fax: (631) 622-6266
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pain Medicine | 207LP2900X | 100207 | Missouri |
| Allopathic & Osteopathic Physicians / Pain Medicine | 207LP2900X | 291245 | New York |
| Allopathic & Osteopathic Physicians / Pain Medicine | 208VP0000X | 291245 | New York |
Profile Details
| NPI number | 1447363312 |
|---|---|
| LBN Legal business name | Johnson, Vincent Gregory |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 16th, 2006 |
| Last updated | Oct 14th, 2022 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1447363312 | NPPES |
| Missouri | MEDICAID | 243881604 | |
| Missouri | Other | 18469031 | |
| Missouri | MEDICAID | 200007670B |
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