Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207P00000X | Emergency Physician | 276402 | NY |
Y | 207PP0204X | Pediatric Emergency Physician | 276402 | NY |
NPI | 1366736811 |
---|---|
Provider Name | Dr. Samantha F Jones |
First Address | Syracuse, NY 13212-4516 |
Second Address | Syracuse, NY 13210-2342 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/06/2011 |
Last Update Date | 30/08/2021 |