Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1100X | Ophthalmic |
NPI | 1083752372 |
---|---|
Provider Name | Prof. Angelo J Jones |
First Address | Philadelphia, PA 19143-1900 |
Second Address | Philadelphia, PA 19143-1900 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/02/2007 |
Last Update Date | 08/07/2007 |