Provider Demographics
NPI:1912882895
Name:JOHNSON, MARSHA ALICIA
Entity type:Individual
Prefix:
First Name:MARSHA
Middle Name:ALICIA
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1770 GRAND CONCOURSE APT 14B
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10457-5547
Mailing Address - Country:US
Mailing Address - Phone:917-553-4023
Mailing Address - Fax:
Practice Address - Street 1:1770 GRAND CONCOURSE APT 14B
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10457-5547
Practice Address - Country:US
Practice Address - Phone:917-553-4023
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-08
Last Update Date:2025-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Single Specialty