Eric Robert Johnson, MD | |
59 West Ave, Brockport, NY 14420 | |
(585) 637-6120 | |
(585) 637-4772 |
Full Name | Eric Robert Johnson |
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Gender | Male |
Speciality | Surgery |
Location | 59 West Ave, Brockport, New York |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1770546277 | NPI | - | NPPES |
01414933 | Medicaid | NY |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208600000X | Surgery | 180005 (New York) | Primary |
Entity Name | Eastern Niagara Hospital Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1063400539 PECOS PAC ID: 1254389620 Enrollment ID: O20050112000475 |
Entity Name | Kenmore Immediate Care Corp Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1124528724 PECOS PAC ID: 5395078224 Enrollment ID: O20190610000542 |
Mailing Address | Practice Location Address |
---|---|
Eric Robert Johnson, MD 59 West Ave, Brockport, NY 14420 Ph: (585) 637-6120 | Eric Robert Johnson, MD 59 West Ave, Brockport, NY 14420 Ph: (585) 637-6120 |
Samantha P Johnson, PA Surgery Medicare: Accepting Medicare Assignments Practice Location: 156 West Ave Fl 3, Brockport, NY 14420 Phone: 585-276-7874 | |
Dr. John P Risolo, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 156 West Ave Fl 3, Brockport, NY 14420 Phone: 585-276-7874 Fax: 585-637-6911 |