Provider Demographics
NPI:1245406701
Name:JONES, BRIDGES DAFFNESE
Entity Type:Individual
Prefix:MS
First Name:BRIDGES
Middle Name:DAFFNESE
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 1:173 CHAUNCEY ST
Mailing Address - Street 2:#3R
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11233-2154
Mailing Address - Country:US
Mailing Address - Phone:718-781-5566
Mailing Address - Fax:
Practice Address - Street 1:173 CHAUNCEY ST
Practice Address - Street 2:#3R
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11233-2154
Practice Address - Country:US
Practice Address - Phone:718-781-5566
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-05
Last Update Date:2008-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY263550-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse