Dr Lawrence Revel Johnson, MD is a
Pathology - Clinical Pathology/laboratory Medicine physician based in Farmingdale, New York. Dr Lawrence Revel Johnson is licensed to practice in New York (license number 296540) and his current practice location is Icon Plc, 123 Smith St., Farmingdale, New York. He can be reached at his office (for appointments etc.) via phone at
(631) 306-9808.
NPI number for Dr Lawrence Revel Johnson is 1881616241 and his current mailing address is 123 Smith St, Farmingdale, New York. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1881616241.
Physician's Profile
| Full Name | Dr Lawrence Revel Johnson |
|---|
| Gender | Male |
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| Speciality | Pathology - Clinical Pathology/laboratory Medicine |
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| Location | Icon Plc, Farmingdale, New York |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1881616241
- Provider Enumeration Date: 07/24/2006
- Last Update Date: 11/16/2018
Medical Identifiers
Medical identifiers for Dr Lawrence Revel Johnson such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1881616241 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207ZC0008X | Pathology - Clinical Informatics | 296540 (New York) | Secondary |
| 207ZH0000X | Pathology - Hematology | 23736 (Oklahoma) | Secondary |
| 207ZH0000X | Pathology - Hematology | MD072950L (Pennsylvania) | Secondary |
| 207ZI0100X | Pathology - Immunopathology | 296540 (New York) | Secondary |
| 207ZP0007X | Pathology - Molecular Genetic Pathology | 296540 (New York) | Secondary |
| 207ZP0102X | Pathology - Anatomic Pathology & Clinical Pathology | 23736 (Oklahoma) | Secondary |
| 207ZP0102X | Pathology - Anatomic Pathology & Clinical Pathology | MD072950L (Pennsylvania) | Secondary |
| 207ZP0102X | Pathology - Anatomic Pathology & Clinical Pathology | 296540 (New York) | Secondary |
| 207ZP0105X | Pathology - Clinical Pathology/laboratory Medicine | 296540 (New York) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Lawrence Revel Johnson is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Dr Lawrence Revel Johnson, MD
123 Smith St,
Farmingdale, NY 11735-1004
Ph: (631) 306-9808 | Dr Lawrence Revel Johnson, MD
Icon Plc, 123 Smith St.,
Farmingdale, NY 11735
Ph: (631) 306-9808 |
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