Search › New York › 363LP2300X
Trevor Johnson
NPI 1669347951 · on the registry since 2025
Practice
- Address
- 367 E Main St Ste A
Waterloo, NY 13165 - Phone
- (315) 787-4977
- Organisation at this address
- Soldiers & Sailors Memorial Hospital
Inferred from a shared address, not stated in the registry.
- Clinicians at this address
- 11
Registry record
- Primary taxonomy
- 363LP2300X
363LP2300X
- Licence states on file
- NY
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2025-10-07
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in New York