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General NPI Number Information
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NPI Number | 1912164237
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Entity Type | Individual
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Provider Name | KELITA R ALSTON JONES PA
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Gender | Female
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Dates
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Enumeration Date | 05/22/2008
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Last Update Date | 03/06/2012
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Provider Practice Location Address
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Address Line | 317 E 17TH ST 2ND FLOOR
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City | NEW YORK
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State | NY
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Zip | 10003-3804
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Country | US
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Telephone | 212-759-5870
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Fax | 212-759-5860
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Provider Business Mailing Address
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Address Line | 73 CROMER RD W
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City | ELMONT
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State | NY
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Zip | 11003-4802
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Country | US
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Telephone | 516-285-1670
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 010301-1
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License Number State | NY
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