Provider Demographics
NPI:1669783148
Name:JOHNNY, PRINCESS E (CRT)
Entity type:Individual
Prefix:MS
First Name:PRINCESS
Middle Name:E
Last Name:JOHNNY
Suffix:
Gender:F
Credentials:CRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 ANTOINETTE CT
Mailing Address - Street 2:
Mailing Address - City:JAMESBURG
Mailing Address - State:NJ
Mailing Address - Zip Code:08831-1124
Mailing Address - Country:US
Mailing Address - Phone:732-744-4225
Mailing Address - Fax:
Practice Address - Street 1:8 ANTOINETTE CT
Practice Address - Street 2:
Practice Address - City:JAMESBURG
Practice Address - State:NJ
Practice Address - Zip Code:08831-1124
Practice Address - Country:US
Practice Address - Phone:732-744-4225
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-29
Last Update Date:2010-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ432A0039200227800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Certified