Individual
ANTONIO N DOMINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
100 E 77TH ST, NEW YORK, NY 10021-1850
(212) 434-2878
Mailing address
PO BOX 26642, NEW YORK, NY 10087-6642
(201) 804-2800
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
235951-1
NY
Other
Enumeration date
01/26/2007
Last updated
07/08/2007
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