Individual
DR. CARMEN M DOMINGUEZ-RAFER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
610 W 158TH ST, NEW YORK, NY 10032
(212) 544-1880
(212) 544-1870
Mailing address
610 W 158TH STREET, NEW YORK, NY 10032
(212) 544-1880
(212) 544-1870
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
198427
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01092608
—
NY
Enumeration date
09/05/2006
Last updated
09/13/2012
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