Individual
DR. IRINA DOMANTOVSKY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
590 5TH AVE FL 11, NEW YORK, NY 10036-4748
(917) 387-7834
Mailing address
PO BOX 220424, GREAT NECK, NY 11022-0424
(917) 387-7834
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
300353
NY
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
300353
NY
Other
Enumeration date
06/14/2010
Last updated
12/15/2022
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