Individual ProviderCole R JohnsonStudent in an Organized Health Care Education/Training ProgramStudent, Health CarePractice Address1 Gustave Levy Place, New York, NY 10029(212) 824-8069PECOS EnrollmentBased on the most recent information from CMS, provider Cole R Johnson does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 6 days ago.Profile DetailsProvider ID1154181386Provider TypeIndividualFull NameJohnson, Cole RTitleDr.CredentialMDGenderMaleSole ProprietorNoEnumeration Date3/22/2024Last Updated3/22/2024Contact InformationPractice LocationPractice Address1 Gustave Levy Place, New York, NY 10029Phone(212) 824-8069FaxUnlisted FaxMailing LocationMailing Address1 Gustave Levy Place, Box 1149, New York, NY 10029PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode390200000XPrimaryDescriptionStudent in an Organized Health Care Education/Training ProgramStudent, Health CareLicenseUnlisted Issuer