Basic Information
| Provider Information | |||||||||
| NPI: | 1093819518 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | JONES | ||||||||
| FirstName: | MONIQUE | ||||||||
| MiddleName: | MCCONDUIT | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | P.O. BOX 4148 | ||||||||
| Address2: | |||||||||
| City: | NEW ORLEANS | ||||||||
| State: | LA | ||||||||
| PostalCode: | 701784148 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5044822080 | ||||||||
| FaxNumber: | 5044836016 | ||||||||
| Practice Location | |||||||||
| Address1: | 1030 LESSEPS ST | ||||||||
| Address2: | |||||||||
| City: | NEW ORLEANS | ||||||||
| State: | LA | ||||||||
| PostalCode: | 701174736 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5049416041 | ||||||||
| FaxNumber: | 5049419991 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/13/2006 | ||||||||
| LastUpdateDate: | 08/11/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | 200173 | LA | Y | Allopathic & Osteopathic Physicians | Pediatrics | 208000000X | M7311 | TX | N | Allopathic & Osteopathic Physicians | Pediatrics |
ID Information
| ID | Type | State | Issuer | Description | 1061271 | 05 | LA | MEDICAID |