Provider Demographics
NPI:1447584321
Name:JONES, ANNIE (MA)
Entity type:Individual
Prefix:
First Name:ANNIE
Middle Name:
Last Name:JONES
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:304 W 88TH ST APT 4A
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-2234
Mailing Address - Country:US
Mailing Address - Phone:617-780-9578
Mailing Address - Fax:
Practice Address - Street 1:511 HEMPSTEAD AVE.
Practice Address - Street 2:SUITE 10
Practice Address - City:WEST HEMPSTEAD
Practice Address - State:NY
Practice Address - Zip Code:11552
Practice Address - Country:US
Practice Address - Phone:516-565-0388
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-25
Last Update Date:2009-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019553235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist