| Mrs Tiffany Lynn Johnson, | |
|
556 Passaic Ave, West Caldwell, NJ 07006-7449 | |
| (973) 808-2273 | |
| Not Available |
| Full Name | Mrs Tiffany Lynn Johnson |
|---|---|
| Gender | Female |
| Speciality | Physician Assistant - Medical |
| Location | 556 Passaic Ave, West Caldwell, New Jersey |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568725174 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363AM0700X | Physician Assistant - Medical | 015417 (New York) | Secondary |
| 363AM0700X | Physician Assistant - Medical | 25MP00317300 (New Jersey) | Primary |
| Entity Name | Excel Urgent Care of Paramus LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1063652220 PECOS PAC ID: 3971656018 Enrollment ID: O20090806000449 |
| Entity Name | Doctors Office of West Caldwell LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1144524786 PECOS PAC ID: 7416130448 Enrollment ID: O20110329000053 |
| Entity Name | Doctors Office of New Jersey LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1508264177 PECOS PAC ID: 5799001731 Enrollment ID: O20150310000671 |
| Mailing Address | Practice Location Address |
|---|---|
| Mrs Tiffany Lynn Johnson, 18 Reynolds Rd, Pequannock, NJ 07440-1707 Ph: (631) 327-2547 | Mrs Tiffany Lynn Johnson, 556 Passaic Ave, West Caldwell, NJ 07006-7449 Ph: (973) 808-2273 |
Devisha Patel, Physician Assistant Medicare: Medicare Enrolled Practice Location: 459 Passaic Ave, West Caldwell, NJ 07006 Phone: 973-276-7898 |
Kifah Khair Abedrabbo, Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 252 Clinton Rd, West Caldwell, NJ 07006 Phone: 862-262-0113 |
Madilyn Terranova, PA-C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 14 Marshall St, West Caldwell, NJ 07006 Phone: 201-259-1606 |