Provider Demographics
NPI:1891468419
Name:JHONSUA A JIMENEZ ARIAS MD, LLC
Entity Type:Organization
Organization Name:JHONSUA A JIMENEZ ARIAS MD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/AUTHORIZED OFFICIAL
Authorized Official - Prefix:DR
Authorized Official - First Name:JHONSUA
Authorized Official - Middle Name:ALBERTO
Authorized Official - Last Name:JIMENEZ ARIAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:862-600-1656
Mailing Address - Street 1:624 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:PATERSON
Mailing Address - State:NJ
Mailing Address - Zip Code:07503
Mailing Address - Country:US
Mailing Address - Phone:862-600-1656
Mailing Address - Fax:
Practice Address - Street 1:624 MAIN ST
Practice Address - Street 2:
Practice Address - City:PATERSON
Practice Address - State:NJ
Practice Address - Zip Code:07503
Practice Address - Country:US
Practice Address - Phone:862-600-1656
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-29
Last Update Date:2021-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty