Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207QA0505X | Family Doctor - Adult Medicine | MD112280 | NY |
Y | 207R00000X | Internist | MD112280 | NY |
Y | 111NI0900X | Internist | MD112280 | NY |
NPI | 1114256310 |
---|---|
Provider Name | Robert Leon Jones |
First Address | New York, NY 10035-2231 |
Second Address | New York, NY 10035-2231 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/12/2009 |
Last Update Date | 29/03/2017 |