Individual
DR. MARIELL E DOMINGUEZ GERMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3196 KENNEDY BLVD, UNION CITY, NJ 07087-2436
(833) 617-0501
Mailing address
3196 KENNEDY BLVD, UNION CITY, NJ 07087-2436
(833) 617-0501
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
25MA10984600
NJ
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/21/2017
Last updated
02/18/2021
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