Provider Demographics
NPI:1134118771
Name:JONES, ELENA L (MD)
Entity Type:Individual
Prefix:
First Name:ELENA
Middle Name:L
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 1:108 E 86TH ST
Mailing Address - Street 2:SUITE # 1N
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10028-1024
Mailing Address - Country:US
Mailing Address - Phone:212-717-0352
Mailing Address - Fax:212-996-5707
Practice Address - Street 1:108 E 86TH ST
Practice Address - Street 2:SUITE # 1N
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10028-1024
Practice Address - Country:US
Practice Address - Phone:212-717-0352
Practice Address - Fax:212-996-5707
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-17
Last Update Date:2009-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY199647207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
H73262Medicare UPIN
2K7801Medicare PIN