Provider Demographics
NPI:1467775460
Name:JONES, JOYCE B (LPN)
Entity Type:Individual
Prefix:MRS
First Name:JOYCE
Middle Name:B
Last Name:JONES
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1065 SUMMIT AVE
Mailing Address - Street 2:APT 2D
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10452-4647
Mailing Address - Country:US
Mailing Address - Phone:646-542-6298
Mailing Address - Fax:646-542-6298
Practice Address - Street 1:1065 SUMMIT AVE
Practice Address - Street 2:APT 2D
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10452-4647
Practice Address - Country:US
Practice Address - Phone:646-542-6298
Practice Address - Fax:646-542-6298
Is Sole Proprietor?:No
Enumeration Date:2010-03-04
Last Update Date:2010-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY257938-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02085849Medicaid