Provider Demographics
NPI:1336266766
Name:JONES, PATRICIA (NP)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:JONES
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:321 GENESEE ST
Mailing Address - Street 2:ATTN: PRACTICE MANAGEMENT
Mailing Address - City:ONEIDA
Mailing Address - State:NY
Mailing Address - Zip Code:13421-2611
Mailing Address - Country:US
Mailing Address - Phone:315-361-2913
Mailing Address - Fax:315-361-2914
Practice Address - Street 1:221 BROAD ST STE 202
Practice Address - Street 2:
Practice Address - City:ONEIDA
Practice Address - State:NY
Practice Address - Zip Code:13421-2178
Practice Address - Country:US
Practice Address - Phone:315-363-5297
Practice Address - Fax:315-363-2829
Is Sole Proprietor?:No
Enumeration Date:2007-03-22
Last Update Date:2017-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY330781363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
R53961Medicare UPIN