Larissa Johnosn

NPI #1629514211 in Valatie, New York

Provider Information

NPI Number: 1629514211
Entity Type: Individual
Name: Larissa Johnosn
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Specialist
Enumeration Date: Jan 6, 2017
Last Updated: Jan 6, 2017

Practice Location

Address: 185 DAHLGREN RD LOT 12
City: Valatie
State: New York
ZIP Code: 12184-4719
Phone: (518) 774-9971

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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