Individual
MR. YURI DOMINGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN, CRNA
Contact information
Practice address
99 E RIVER DR, 5TH FLOOR, EAST HARTFORD, CT 06108-3288
(860) 282-4022
(860) 289-0746
Mailing address
99 E RIVER DR, 5TH FLOOR, EAST HARTFORD, CT 06108-3288
(860) 282-4022
(860) 289-0746
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
001022
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004209426
—
CT
Enumeration date
03/22/2006
Last updated
05/06/2014
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