Provider Demographics
NPI:1518318526
Name:JONES, VENICE
Entity Type:Individual
Prefix:
First Name:VENICE
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 1:10 CHAPEL AVE
Mailing Address - Street 2:
Mailing Address - City:MERCHANTVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08109-5102
Mailing Address - Country:US
Mailing Address - Phone:856-254-7052
Mailing Address - Fax:856-488-8249
Practice Address - Street 1:10 CHAPEL AVE
Practice Address - Street 2:
Practice Address - City:MERCHANTVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08109-5102
Practice Address - Country:US
Practice Address - Phone:856-254-7052
Practice Address - Fax:856-488-8249
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-30
Last Update Date:2016-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171W00000XOther Service ProvidersContractorGroup - Single Specialty