Individual
LAURA S DOMINICI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
450 BROOKLINE AVE, DANA FARBER CANCER INSTITUTE, BOSTON, MA 02215-5418
(617) 632-3521
(617) 582-7730
Mailing address
111 CYPRESS ST, BROOKLINE, MA 02445-6002
(857) 307-0896
Taxonomy
Speciality
Code
Description
License number
State
2086X0206X
Surgical Oncology Physician
Primary
240034
MA
2086X0206X
Surgical Oncology Physician
M9981
TX
390200000X
Student in an Organized Health Care Education/Training Program
218143
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110083330A
—
MA
Enumeration date
03/13/2008
Last updated
05/15/2012
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