Individual
MYRNA B. DOMINGO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
3959 BROADWAY, 7 TOWER, NEW YORK, NY 10032-3784
(212) 342-8600
(212) 342-8598
Mailing address
81 CLINTON PARK DR, BERGENFIELD, NJ 07621-2452
(201) 439-0347
(212) 342-8598
Taxonomy
Speciality
Code
Description
License number
State
363LN0000X
Neonatal Nurse Practitioner
Primary
F350239-1
NY
Other
Enumeration date
08/16/2007
Last updated
08/16/2007
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