Individual
DR. MATTHEW LEE DOMINGUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
550 1ST AVE, NEW YORK, NY 10016-6402
(212) 263-7264
(212) 263-8525
Mailing address
550 1ST AVE, NEW YORK, NY 10016-6402
(212) 263-7264
(212) 263-8525
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
0361390776
IL
2084P0800X
Psychiatry Physician
193103
AK
2084P0800X
Psychiatry Physician
Primary
290023
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NA
NA
—
Enumeration date
04/01/2013
Last updated
09/20/2024
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