Provider Demographics
NPI:1285897579
Name:JONES, JEWEL PETERGAY (MD)
Entity type:Individual
Prefix:DR
First Name:JEWEL
Middle Name:PETERGAY
Last Name:JONES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:483 48TH AVE
Mailing Address - Street 2:#3B
Mailing Address - City:LONG ISLAND CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11109-5538
Mailing Address - Country:US
Mailing Address - Phone:917-495-9829
Mailing Address - Fax:
Practice Address - Street 1:483 48TH AVE
Practice Address - Street 2:#3B
Practice Address - City:LONG ISLAND CITY
Practice Address - State:NY
Practice Address - Zip Code:11109-5538
Practice Address - Country:US
Practice Address - Phone:917-495-9829
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-07
Last Update Date:2011-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY263167-1207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine