Healthcare Provider Details

I. General information

NPI: 1255140794
Provider Name (Legal Business Name): LIA N JONES ANP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/30/2024
Last Update Date: 09/03/2026
Certification Date: 02/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

32 CLINTON STREET
PATERSON NJ
07522
US

IV. Provider business mailing address

PATERSON COMMUNITY HEALTH CENTER 32 CLINTON STREET
PATERSON NJ
07522
US

V. Phone/Fax

Practice location:
  • Phone: 973-790-6594
  • Fax: 973-389-2197
Mailing address:
  • Phone: 973-790-6594
  • Fax: 973-389-2197

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number26NJ15074400
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: