Individual
MARIANE DOMINGOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
188 CANASAWACTA TER, NORWICH, NY 13815-3606
(680) 287-1927
Mailing address
188 CANASAWACTA TER, NORWICH, NY 13815-3606
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
012321
NY
Other
Enumeration date
12/04/2025
Last updated
12/04/2025
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