Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YP0228X | Pediatric Otolaryngology | 182047 | NY |
NPI | 1073602215 |
---|---|
Provider Name | Jacqueline Eleanor Jones |
First Address | New York, NY 10128-1211 |
Second Address | New York, NY 10128-1211 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/10/2006 |
Last Update Date | 16/08/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
182047 | LICENSE (01) | NY |
E07130 | (02) |