MEDICARE: ELENA L JONES MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207N00000X	Dermatology Physician	199647	NY

General Provider Information

NPI Number	:	1134118771
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELENA L JONES MD

Provider Business Mailing Address
First Line	:	108 E 86TH ST
Second Line	:	SUITE # 1N
City	:	NEW YORK
State	:	NY
Zip	:	10028-1024
Country	:	US
Telephone Number	:	212-717-0352
Fax Number	:	212-996-5707

Provider Business Practice Location Address
First Line	:	108 E 86TH ST
Second Line	:	SUITE # 1N
City	:	NEW YORK
State	:	NY
Zip	:	10028-1024
Country	:	US
Telephone Number	:	212-717-0352
Fax Number	:	212-996-5707

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/17/2005
Last Update Date	:	06/20/2009

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