Provider Demographics
NPI:1962189076
Name:JONES, GRADIA (OCCUPATIONAL THERAPY)
Entity type:Individual
Prefix:MS
First Name:GRADIA
Middle Name:
Last Name:JONES
Suffix:
Gender:F
Credentials:OCCUPATIONAL THERAPY
Other - Prefix:MS
Other - First Name:GRADIA
Other - Middle Name:
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OCCUPATIONAL THERAPY
Mailing Address - Street 1:2190 MADISON AVE APT 4H
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10037-2229
Mailing Address - Country:US
Mailing Address - Phone:347-339-5423
Mailing Address - Fax:
Practice Address - Street 1:2190 MADISON AVE APT 4H
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10037-2229
Practice Address - Country:US
Practice Address - Phone:347-339-5423
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-30
Last Update Date:2023-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY402630224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant