Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225X00000X | Occupational Therapist | 023598 | NY |
Y | 225XP0200X | Occupational Therapist - Pediatrics | 023598 | NY |
NPI | 1023672128 |
---|---|
Provider Name | Akinwunmi O Jones |
First Address | Bronx, NY 10457-3245 |
Second Address | Bronx, NY 10451-3137 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/04/2019 |
Last Update Date | 01/05/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
023598 | (05) | NY |