Basic Information
| Provider Information | |||||||||
| NPI: | 1790869949 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | JONES | ||||||||
| FirstName: | JEANINE | ||||||||
| MiddleName: | MARIE | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | MPT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 955 YONKERS AVE | ||||||||
| Address2: | STE 109 | ||||||||
| City: | YONKERS | ||||||||
| State: | NY | ||||||||
| PostalCode: | 107043060 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9147767310 | ||||||||
| FaxNumber: | 9147767566 | ||||||||
| Practice Location | |||||||||
| Address1: | 955 YONKERS AVE | ||||||||
| Address2: | STE 109 | ||||||||
| City: | YONKERS | ||||||||
| State: | NY | ||||||||
| PostalCode: | 107043060 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9147767310 | ||||||||
| FaxNumber: | 9147767566 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/24/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 027475 | NY | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
ID Information
| ID | Type | State | Issuer | Description | 211826P | 01 | NY | HIP OF NEW YORK | OTHER | 694844 | 01 | NY | MANAGED PHYSICAL NETWORK | OTHER | 41454270 | 01 | NY | MVP | OTHER | Q30A92 | 01 | NY | EMPIRE BLUE CROSS & BLUE | OTHER | 30201 | 01 | NY | ORTHONET | OTHER | 000000106035 | 01 | NY | GHI - HMO | OTHER | 7659879 | 01 | NY | AETNA PPO / POS | OTHER | 1321869 | 01 | NY | AETNA HMO | OTHER | P3623168 | 01 | NY | OXFORD HEALTH PLANS | OTHER |