Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204D00000X | Neuromusculoskeletal Medicine (NMM) | 213062 | NY |
Y | 2081S0010X | Sports Medicine | 213062 | NY |
Y | 213ES0000X | Sports Medicine | 213062 | NY |
NPI | 1285708800 |
---|---|
Provider Name | Dr. Scott Allen Jones |
First Address | Melville, NY 11747 |
Second Address | Smithtown, NY 11787-2978 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/11/2006 |
Last Update Date | 29/09/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
213062-3B | WORKERS' COMPENSATION (01) | NY |
H03892 | (02) | NY |