Provider Demographics
NPI:1538220199
Name:JONES, MICHAEL ABOU (MD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:ABOU
Last Name:JONES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:450 FASHION AVE STE 309
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10123-0309
Mailing Address - Country:US
Mailing Address - Phone:212-594-0423
Mailing Address - Fax:212-594-2468
Practice Address - Street 1:450 FASHION AVE STE 309
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10123-0309
Practice Address - Country:US
Practice Address - Phone:212-594-0423
Practice Address - Fax:212-594-2468
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY172400207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYI DO NOT KNOW #Medicaid
NYI DO NOT KNOW #Medicaid
NY15E571Medicare ID - Type Unspecified