Provider Demographics
NPI:1023194768
Name:JONES, AKIM (DPT)
Entity Type:Individual
Prefix:
First Name:AKIM
Middle Name:
Last Name:JONES
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1250 WATERS PLACE
Mailing Address - Street 2:SUITE 501
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10461-2720
Mailing Address - Country:US
Mailing Address - Phone:718-409-9444
Mailing Address - Fax:718-409-0236
Practice Address - Street 1:3611 E TREMONT AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10465-2053
Practice Address - Country:US
Practice Address - Phone:718-904-9581
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-27
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY025953174400000X
NY025953-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY133586197OtherTAX ID#
NYQ04V31OtherEMPIRE BC/BS #
NYQ04V31OtherEMPIRE BCBS
NYQ09Z02Medicare ID - Type UnspecifiedMEDICARE #
NY133586197OtherTAX ID#
NYQ04V31OtherEMPIRE BC/BS #