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NPI Code Detail

MEDICARE: MISS JESSICA JONES

MEDICARE: MISS JESSICA JONES
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1104100000XSocial Worker

General Provider Information

NPI Number : 1437771839
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS JESSICA JONES
Provider Business Mailing Address
First Line : 239 GOLDEN HILL LN
Second Line :
City : KINGSTON
State : NY
Zip : 12401-6452
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 239 GOLDEN HILL LN
Second Line :
City : KINGSTON
State : NY
Zip : 12401-6452
Country : US
Telephone Number : 845-340-4105
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/08/2020
Last Update Date : 05/08/2020

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Directions to “ MISS JESSICA JONES ” Practice Location

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