Provider Demographics
NPI:1679883458
Name:JONES, GIFTA LAUREL (PHARMD)
Entity type:Individual
Prefix:DR
First Name:GIFTA
Middle Name:LAUREL
Last Name:JONES
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9205 WHITNEY AVE
Mailing Address - Street 2:APT # B-42
Mailing Address - City:ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11373-2279
Mailing Address - Country:US
Mailing Address - Phone:718-446-1097
Mailing Address - Fax:
Practice Address - Street 1:8213 37TH AVE
Practice Address - Street 2:
Practice Address - City:JACKSON HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11372-7011
Practice Address - Country:US
Practice Address - Phone:718-565-1473
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-14
Last Update Date:2010-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY054919183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist