Provider Demographics
NPI:1144776105
Name:JONES, OLUWAFUNKE
Entity Type:Individual
Prefix:
First Name:OLUWAFUNKE
Middle Name:
Last Name:JONES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:468 E 140TH ST RM 120
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10454-2752
Mailing Address - Country:US
Mailing Address - Phone:718-292-4482
Mailing Address - Fax:718-585-5085
Practice Address - Street 1:468 E 140TH ST
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10454-2752
Practice Address - Country:US
Practice Address - Phone:718-292-4482
Practice Address - Fax:718-585-5085
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-30
Last Update Date:2017-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2680067252Y00000X
NY026924235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No252Y00000XAgenciesEarly Intervention Provider Agency