Individual
MS. CLAUDETTE MARCIA DOMINIQUE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.N
Contact information
Practice address
1376 OHIO AVE, BAYSHORE, BAY SHORE, NY 11706-5215
(631) 665-1949
Mailing address
1376 OHIO AVE, BAYSHORE,NY, BAY SHORE, NY 11706-5215
(631) 665-1949
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
8068345
NY
Other
Enumeration date
05/14/2013
Last updated
05/14/2013
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