Amanda C. Johnson
Pediatric Critical Care Doctor
55 Lake Ave N
Worcester
, Massachusetts 01655-0002
Amanda C. Johnson
Pediatric Critical Care Doctor
55 Lake Ave N
Worcester
, Massachusetts 01655-0002
(508) 334-1977
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About
Features
Specialties
- Pediatric Critical Care Doctor
Languages spoken
- English
Location
First Address
- Amanda C. Johnson
- Po Box 415348
- Boston, MA
- Zip : 02241-5348
- Fax : (508) 334-1977
- Phone : (800) 225-8885
Second Address
- Amanda C. Johnson
- 55 Lake Ave N
- Worcester, MA
- Zip : 01655-0002
- Fax : (774) 443-2062
- Phone : (774) 442-2164
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 2080P0203X | Pediatric Critical Care Doctor | 262592 | MA |
National Provider Identifier
| NPI | 1285995589 |
|---|---|
| Provider Name | Amanda C. Johnson |
| First Address | Boston, MA 02241-5348 |
| Second Address | Worcester, MA 01655-0002 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 04/06/2012 |
| Last Update Date | 10/11/2020 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 110099386A | (05) | MA |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.