Individual
GAETEN J DOMINIC
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RNFA
Contact information
Practice address
3138 S 18TH ST, PHILADELPHIA, PA 19145-5439
(215) 817-0076
Mailing address
3138 S 18TH ST, PHILADELPHIA, PA 19145-5439
(215) 817-0076
Taxonomy
Speciality
Code
Description
License number
State
163WR0006X
Registered Nurse First Assistant
Primary
RN253608L
PA
Other
Enumeration date
02/10/2018
Last updated
02/10/2018
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