Individual
DOMINIC DON KALATHIVILA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1 PACE PLZ, NEW YORK, NY 10038-1598
(866) 722-3338
Mailing address
605 LOWELL AVE, NEW HYDE PARK, NY 11040-3016
(516) 884-2047
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
349267
NY
Other
Enumeration date
06/06/2022
Last updated
06/06/2022
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