Individual
MICHELLE FRANCES DOMINGUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4422 3RD AVE, BRONX, NY 10457-2545
(718) 960-6202
Mailing address
87-89 NICHOLS ST APT 4, NEWARK, NJ 07105-6611
(201) 707-7984
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
25MA11444500
NJ
208M00000X
Hospitalist Physician
Primary
25MA11444500
NJ
Other
Enumeration date
04/19/2019
Last updated
06/15/2023
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