Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | LL09887 | MD |
NPI | 1083270979 |
---|---|
Provider Name | Jones Thomas |
First Address | New Hyde Park, NY 11040-4343 |
Second Address | New Hyde Park, NY 11040-4343 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/05/2019 |
Last Update Date | 29/06/2019 |