MEDICARE: MRS. JENNIFER MARIE JONES PA-C

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
1	363A00000X	Physician Assistant	003394	CT
2	363A00000X	Physician Assistant	019052-1	NY

General Provider Information

NPI Number	:	1841663150
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JENNIFER MARIE JONES PA-C

Provider Business Mailing Address
First Line	:	157 SHELTER ROCK RD
Second Line	:	UNIT 20
City	:	DANBURY
State	:	CT
Zip	:	06810-7051
Country	:	US
Telephone Number	:	845-661-7688
Fax Number	:

Provider Business Practice Location Address
First Line	:	157 SHELTER ROCK RD
Second Line	:	UNIT 20
City	:	DANBURY
State	:	CT
Zip	:	06810-7051
Country	:	US
Telephone Number	:	845-661-7688
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/09/2015
Last Update Date	:	11/09/2015

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