Healthcare Provider Details

I. General information

NPI: 1891990016
Provider Name (Legal Business Name): LORI JONES MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/18/2007
Last Update Date: 03/04/2025
Certification Date: 03/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 FRUIT ST
BOSTON MA
02114-2621
US

IV. Provider business mailing address

DIVISION OF UROLOGY 11 NEVINS STREET, SUITE 303
BRIGHTON MA
02135-3514
US

V. Phone/Fax

Practice location:
  • Phone: 617-726-0122
  • Fax:
Mailing address:
  • Phone: 617-787-8181
  • Fax: 617-787-4644

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number288752
License Number StateMA
# 3
Primary TaxonomyY
Taxonomy Code2088F0040X
TaxonomyUrogynecology and Reconstructive Pelvic Surgery (Urology) Physician
License Number288752
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: