Individual
MS. EWELINA DOMANOWSKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
75 N COUNTRY RD, PORT JEFFERSON, NY 11777-2119
(631) 473-1320
Mailing address
57 N LEWIS AVE, LINDENHURST, NY 11757-4229
(631) 988-2395
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
09/15/2020
Last updated
08/15/2023
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