Individual ProviderJeremy JohnsonRegistered NurseNursing Service ProvidersPractice Address12 N Broadway Apt 2b, Yonkers, NY 10701-7064(718) 866-4569(516) 800-3898PECOS EnrollmentBased on the most recent information from CMS, provider Jeremy 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 yesterday at 9:43 AM.Profile DetailsProvider ID1477168193Provider TypeIndividualFull NameJohnson, JeremyTitleMr.CredentialRNGenderMaleSole ProprietorNoEnumeration Date9/10/2020Last Updated9/11/2020Contact InformationPractice LocationPractice Address12 N Broadway Apt 2b, Yonkers, NY 10701-7064Phone(718) 866-4569FaxUnlisted FaxMailing LocationMailing Address576 N 1st St, New Hyde Park, NY 11040-2820Phone(516) 800-3898FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode163W00000XPrimaryDescriptionRegistered NurseNursing Service ProvidersLicense794604New York