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General NPI Number Information
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NPI Number | 1649061136
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Entity Type | Individual
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Provider Name | MR. CHAD-ANTHONY JONES
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Gender | Male
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Dates
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Enumeration Date | 05/14/2025
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Last Update Date | 05/14/2025
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Provider Practice Location Address
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Address Line | 620 MADISON ST STE 120
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City | SYRACUSE
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State | NY
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Zip | 13210-2338
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Country | US
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Telephone | 315-426-3600
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Fax | 315-426-3605
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Provider Business Mailing Address
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Address Line | 1141 E 82ND ST
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City | BROOKLYN
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State | NY
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Zip | 11236-4701
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Country | US
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Telephone | 347-598-8750
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WP0809X
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Taxonomy Name | Adult Psychiatric/Mental Health Registered Nurse
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License Number | 962474
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License Number State | NY
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