Healthcare Provider Details

I. General information

NPI: 1083555882
Provider Name (Legal Business Name): JORDON AMBER JONES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/03/2026
Last Update Date: 04/09/2026
Certification Date: 04/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2830 EASTON AVE
BETHLEHEM PA
18017-4204
US

IV. Provider business mailing address

301 RIVERFRONT BLVD APT 410
ELMWOOD PARK NJ
07407-1041
US

V. Phone/Fax

Practice location:
  • Phone: 484-526-3555
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMT236159
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: