Provider Demographics
NPI:1649294992
Name:JONES, JANEL M (PT, DPT)
Entity type:Individual
Prefix:
First Name:JANEL
Middle Name:M
Last Name:JONES
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:JANEL
Other - Middle Name:M
Other - Last Name:BOYLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:171 FRANKLIN TPKE
Mailing Address - Street 2:
Mailing Address - City:WALDWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:07463-1849
Mailing Address - Country:US
Mailing Address - Phone:201-589-0117
Mailing Address - Fax:
Practice Address - Street 1:171 FRANKLIN TPKE
Practice Address - Street 2:
Practice Address - City:WALDWICK
Practice Address - State:NJ
Practice Address - Zip Code:07463-1849
Practice Address - Country:US
Practice Address - Phone:201-589-0117
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2010-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD21988225100000X
IA04001225100000X
MO2008002533225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA33594OtherBLUE CROSS BLUE SHIELD
MO39743011OtherBLUE CROSS BLUE SHIELD
IA0665711Medicaid
IA0665711Medicaid
MO39743011OtherBLUE CROSS BLUE SHIELD