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Contact Information

VINCENT G JOHNSON, DO
500 W MAIN ST STE 116
BABYLON, NY11702-3032
 Phone: 631-422-6166
 Fax: 631-622-6266
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pain Medicine

208VP0000X 72 Physician/Pain Management
 

Pain Medicine

207LP2900X 05 Physician/Anesthesiology
Indicates primary specialty

NPI Profile & details for VINCENT G JOHNSON · (Male)

NPI # 1447363312
Status Active
Credentials DO (Doctor of Osteopathic)
Entity Individual
Enumeration date 08/16/2006
Last updated 10/14/2022 - About 4 years ago
Sole proprietor 1 No
Identifiers
  • MO License # 100207
  • NY License # 291245
  • KS Medicaid 200007670B
  • MO Medicaid 243881604
  • MO Other 18469031 BCBS OF KANSAS CITY
Hospital affiliation(s)
  • SOUTHSIDE HOSPITAL - (Acute Care)
    301 EAST MAIN STREET
    BAY SHORE, NY 11706
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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