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Individual

CHRISTINE DOMINIQUE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPN

Contact information

Practice address
18011 JAMAICA AVE, JAMAICA, NY 11432-5620
(516) 787-7064
Mailing address
18011 JAMAICA AVE, JAMAICA, NY 11432-5620
(516) 787-7064

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
306327
NY

Other

Enumeration date
12/06/2016
Last updated
12/06/2016
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