National Provider Identifier

Emily E Johnson, PA

Emily E Johnson, PA is listed in the NPPES registry with a primary specialty of Physician Assistant in Addison, NY and a listed phone number of (607) 359-2291.

NPI 1720620479Addison, NYPhysician Assistant

Profile Overview

NPI
1720620479
Provider Type
Individual
Primary Specialty
Physician Assistant
Enumeration Date
October 15, 2019
Last Updated
September 24, 2024

Practice Location

  • 15 Community Dr
  • Addison, NY 14801-1140

Phone: (607) 359-2291

Mailing Address

  • 600 Ivy St Ste 206
  • Elmira, NY 14905-1627

Specialties

  • Physician Assistant (363A00000X)
Full Record
NPI
1720620479
Entity Type
Individual
Last Name
Johnson
First Name
Emily
Middle Name
E
Credential
PA
Provider Other Last Name
Hostottle
Provider Other First Name
Emily
Provider Other Middle Name
E
Provider Other Credential Text
PA
Provider Other Last Name Type Code
1
Mailing Street Address
600 Ivy St Ste 206
Mailing City
Elmira
Mailing State
NY
Mailing ZIP Code
14905-1627
Mailing Country
US
Mailing Phone
(607) 271-2050
Mailing Fax
(607) 271-2071
Practice Street Address
15 Community Dr
Practice City
Addison
Practice State
NY
Practice ZIP Code
14801-1140
Practice Country
US
Practice Phone
(607) 359-2291
Practice Fax
(607) 359-2294
Enumeration Date
October 15, 2019
Last Updated
September 24, 2024
Sex
Female
Sole Proprietor
No
Certification Date
September 24, 2024
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Physician Assistant (363A00000X)
Other Identifiers
05936672 (NY), 103756780 (PA)