IndividualActive
Jesse Johnson, PA
NPI 1003042664 · Medical Physician Assistant · Brooklyn, NY
Provider details
- NPI number
- 1003042664
- Entity type
- Individual
- Primary specialty
- Medical Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- PA
- Sex
- Male
- Sole proprietor
- Yes
- License
- 013190 (NY)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Practice location
3201 Kings Hwy
Brooklyn, NY 11234-2625
Phone: (718) 951-2901
Approximate (ZIP-level) locationGet directions
Mailing address
3201 Kings Hwy
Brooklyn, NY 11234-2625
Registry dates
- Enumerated
- 2009-06-09
- Last updated
- 2016-08-19
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.