Individual
JOANNE DOMINGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
2800 MARCUS AVE, NEW HYDE PARK, NY 11042-1008
(516) 622-6076
Mailing address
2800 MARCUS AVE, NEW HYDE PARK, NY 11042-1008
(516) 622-6076
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
000682-1
NY
363AS0400X
Surgical Physician Assistant
Primary
000682-1
NY
Other
Enumeration date
05/04/2007
Last updated
09/11/2025
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