Basic Information
| Provider Information | |||||||||
| NPI: | 1346385697 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | JOHNSON MILLER | ||||||||
| FirstName: | DENISE | ||||||||
| MiddleName: | LYNN | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | JOHNSON | ||||||||
| OtherFirstName: | DENISE | ||||||||
| OtherMiddleName: | LYNN | ||||||||
| OtherNamePrefix: | DR. | ||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | MD | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 1945 HWY 33 | ||||||||
| Address2: | ACKERMAN 5 SOUTH | ||||||||
| City: | NEPTUNE | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 077534859 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7322637960 | ||||||||
| FaxNumber: | 7322637961 | ||||||||
| Practice Location | |||||||||
| Address1: | 1945 ROUTE 33 | ||||||||
| Address2: | 5TH FLOOR | ||||||||
| City: | NEPTUNE | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 077530000 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7322637960 | ||||||||
| FaxNumber: | 7322637961 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/21/2007 | ||||||||
| LastUpdateDate: | 05/07/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2086X0206X | 25MA09258300 | NJ | Y | Allopathic & Osteopathic Physicians | Surgery | Surgical Oncology |
No ID Information.