Provider Demographics
NPI:1770513079
Name:JOHNSON, ALEXIS (MD)
Entity type:Individual
Prefix:DR
First Name:ALEXIS
Middle Name:
Last Name:JOHNSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:506 LENOX AVENUE
Mailing Address - Street 2:HARLEM HOSPITAL CENTER DEPARTMENT OF EMERGENCY MEDICINE
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10037
Mailing Address - Country:US
Mailing Address - Phone:914-740-4466
Mailing Address - Fax:
Practice Address - Street 1:DAVIS AVENUE & EAST POST ROAD
Practice Address - Street 2:WHITE PLAINS HOSPITAL, DEPARTMENT OF EMERGENCY MEDICINE
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10601
Practice Address - Country:US
Practice Address - Phone:914-681-1158
Practice Address - Fax:914-681-2878
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2008-01-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY231556207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine