Provider Demographics
NPI:1548010671
Name:JONES, ASIA RENEE
Entity type:Individual
Prefix:
First Name:ASIA
Middle Name:RENEE
Last Name:JONES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 VERMELLA WAY APT 2078
Mailing Address - Street 2:
Mailing Address - City:UNION
Mailing Address - State:NJ
Mailing Address - Zip Code:07083-2630
Mailing Address - Country:US
Mailing Address - Phone:504-912-6161
Mailing Address - Fax:
Practice Address - Street 1:120 E 1ST AVE
Practice Address - Street 2:
Practice Address - City:ROSELLE
Practice Address - State:NJ
Practice Address - Zip Code:07203-1210
Practice Address - Country:US
Practice Address - Phone:908-241-0476
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-22
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI04361600183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist