Healthcare Provider Details

I. General information

NPI: 1215423728
Provider Name (Legal Business Name): FELICE A JONES-LEE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/09/2018
Last Update Date: 09/29/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

245 NEW YORK AVE
BAY SHORE NY
11706-3311
US

IV. Provider business mailing address

245 NEW YORK AVE
BAY SHORE NY
11706-3311
US

V. Phone/Fax

Practice location:
  • Phone: 631-431-0573
  • Fax:
Mailing address:
  • Phone: 631-431-0573
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number455197
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: