Individual
RODOLFO M DOMINGO
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1000 MONTAUK HWY, GOOD SAMARITAN HOSPITAL MEDICAL CENTER, WEST ISLIP, NY 11795
(631) 376-4088
Mailing address
3 BOYLE ROAD, SELDEN, NY 11784
(631) 736-3372
(631) 736-1332
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
1870381
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01577339
—
NY
Enumeration date
12/22/2005
Last updated
07/08/2007
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