Individual
DR. JONATHAN MANUEL DOMINGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7919 KENNEDY BLVD, NORTH BERGEN, NJ 07047-4137
(201) 528-3664
(201) 528-3662
Mailing address
7919 KENNEDY BLVD, NORTH BERGEN, NJ 07047-4137
(201) 528-3664
(201) 528-3662
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
25MA10256200
NJ
Other
Enumeration date
06/01/2015
Last updated
06/13/2024
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