Provider Demographics
NPI:1700113602
Name:MONIQUE DE FOUR JONES MD,PC
Entity Type:Organization
Organization Name:MONIQUE DE FOUR JONES MD,PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:MONIQUE
Authorized Official - Middle Name:
Authorized Official - Last Name:DEFOUR JONES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-869-8071
Mailing Address - Street 1:444 COMMUNITY DR
Mailing Address - Street 2:SUITE 201
Mailing Address - City:MANHASSET
Mailing Address - State:NY
Mailing Address - Zip Code:11030-3820
Mailing Address - Country:US
Mailing Address - Phone:516-869-8071
Mailing Address - Fax:516-869-8019
Practice Address - Street 1:444 COMMUNITY DR
Practice Address - Street 2:SUITE 201
Practice Address - City:MANHASSET
Practice Address - State:NY
Practice Address - Zip Code:11030-3820
Practice Address - Country:US
Practice Address - Phone:516-869-8071
Practice Address - Fax:516-869-8019
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-13
Last Update Date:2009-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty