Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0120X | Pediatric Surgery | 267432 | NY |
N | 2086S0120X | Pediatric Surgery | MD439278 | PA |
NPI | 1205149242 |
---|---|
Provider Name | Vinci Samuel Jones |
First Address | Babylon, NY 11702-1314 |
Second Address | Babylon, NY 11702-1314 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/07/2010 |
Last Update Date | 10/03/2014 |