Healthcare Provider Details

I. General information

NPI: 1285773077
Provider Name (Legal Business Name): MARJORIE E JONES MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/06/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35 BRINKERHOFF AVE
TEANECK NJ
07666-3125
US

IV. Provider business mailing address

35 BRINKERHOFF AVE
TEANECK NJ
07666-3125
US

V. Phone/Fax

Practice location:
  • Phone: 201-836-8666
  • Fax:
Mailing address:
  • Phone: 201-836-8666
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number18494
License Number StateNJ

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: