Provider Demographics
NPI:1609598416
Name:JONES, BRANDON (CASE MGR, COMM,PRES)
Entity Type:Individual
Prefix:
First Name:BRANDON
Middle Name:
Last Name:JONES
Suffix:
Gender:M
Credentials:CASE MGR, COMM,PRES
Other - Prefix:
Other - First Name:COMMISSIONER BRANDON
Other - Middle Name:
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CM, PRESIDENT, COMM,
Mailing Address - Street 1:1075 WEBSTER AVE # 4B5
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10456-5931
Mailing Address - Country:US
Mailing Address - Phone:212-470-1465
Mailing Address - Fax:646-921-3189
Practice Address - Street 1:51 E 125TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10035-1685
Practice Address - Country:US
Practice Address - Phone:212-470-1465
Practice Address - Fax:646-921-3189
Is Sole Proprietor?:No
Enumeration Date:2022-09-19
Last Update Date:2023-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY001135OtherNYS DOH