Organization
PRIMARY CARE GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DOMENICA FANTINI DO (PHYSICIAN)
(908) 505-5141
Entity
Organization
Contact information
Practice address
2 WESTFIELD AVE, CLARK, NJ 07066-3226
(908) 505-5141
Mailing address
2 WESTFIELD AVE, CLARK, NJ 07066-3226
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
08/05/2019
Last updated
08/05/2019
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