Provider Demographics
NPI:1114071859
Name:JONES, DEBORAH POLLARD (MD)
Entity Type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:POLLARD
Last Name:JONES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800A 5TH AVE STE 401
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10065-7232
Mailing Address - Country:US
Mailing Address - Phone:212-230-1081
Mailing Address - Fax:
Practice Address - Street 1:800A 5TH AVE STE 401
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10065-7232
Practice Address - Country:US
Practice Address - Phone:212-230-1081
Practice Address - Fax:212-230-1359
Is Sole Proprietor?:No
Enumeration Date:2007-01-22
Last Update Date:2017-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY231770207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02558592Medicaid
NY02558592Medicaid
NYI05769Medicare UPIN