Individual
DOMINIC PAMINTUAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
569 RIVER RD, FAIR HAVEN, NJ 07704-3262
(732) 530-0100
(732) 530-5895
Mailing address
PO BOX 8519, RED BANK, NJ 07701-8519
(732) 460-9840
(732) 460-9848
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
25MA08618100
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
611521900
US DEPT OF LABOR
VA
01
—
611521901
US DEPT OF LABOR
VA
01
—
611521902
US DEPT OF LABOR
VA
Enumeration date
08/01/2006
Last updated
08/02/2010
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