Individual ProviderBashirat Olushola JohnsonStudent in an Organized Health Care Education/Training ProgramStudent, Health CarePractice Address1901 1st Avenue, 15th Floor, Room 15b1, New York, NY 10029(212) 423-6271PECOS EnrollmentBased on the most recent information from CMS, provider Bashirat Olushola 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 ID1164154043Provider TypeIndividualFull NameJohnson, Bashirat OlusholaTitleDr.GenderFemaleSole ProprietorNoEnumeration Date6/29/2022Last Updated6/29/2022Contact InformationPractice LocationPractice Address1901 1st Avenue, 15th Floor, Room 15b1, New York, NY 10029Phone(212) 423-6271FaxUnlisted FaxMailing LocationMailing Address1901 1st Avenue, 15th Floor, Room 15b1, New York, NY 10029Phone(212) 423-6271FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode390200000XPrimaryDescriptionStudent in an Organized Health Care Education/Training ProgramStudent, Health CareLicenseUnlisted Issuer