Provider Demographics
NPI:1790918662
Name:JONES, GLORIA LYNNETTE
Entity Type:Individual
Prefix:MISS
First Name:GLORIA
Middle Name:LYNNETTE
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 1:227 PALISADE AVE APT 2J
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10703-3124
Mailing Address - Country:US
Mailing Address - Phone:914-874-7941
Mailing Address - Fax:
Practice Address - Street 1:7 EDGEMONT CIR
Practice Address - Street 2:
Practice Address - City:SCARSDALE
Practice Address - State:NY
Practice Address - Zip Code:10583-2615
Practice Address - Country:US
Practice Address - Phone:914-723-7783
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-26
Last Update Date:2009-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY069373164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse