Individual
MS. CARMELITA TAWANNA DOMINGO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
64 LINDEN AVE, HEMPSTEAD, NY 11550-6140
(718) 598-5582
Mailing address
64 LINDEN AVE, HEMPSTEAD, NY 11550-6140
(718) 598-5582
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
241338-
NY
Other
Enumeration date
07/06/2010
Last updated
07/06/2010
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