Basic Information
Provider Information
NPI: 1972742930
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: JONES
FirstName: ARTILYA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: NP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 20 RESEARCH PKWY STE C
Address2:  
City: OLD SAYBROOK
State: CT
PostalCode: 064754214
CountryCode: US
TelephoneNumber: 8003703651
FaxNumber: 8605100020
Practice Location
Address1: 10 LANGLEY RD
Address2: STE 300
City: NEWTON
State: MA
PostalCode: 024591972
CountryCode: US
TelephoneNumber: 8003703651
FaxNumber: 8605100020
Other Information
ProviderEnumerationDate: 02/16/2009
LastUpdateDate: 03/30/2009
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163W00000XRN2258380MAN Nursing Service ProvidersRegistered Nurse 
163WG0600XRN2258380MAY Nursing Service ProvidersRegistered NurseGerontology

No ID Information.


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