Individual
JOSELITO B. DOMINGO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
59 KOCH AVE, MORRIS PLAINS, NJ 07950-4400
(973) 538-1800
Mailing address
59 KOCH AVE, MORRIS PLAINS, NJ 07950-4400
(973) 588-5300
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
25MA06012200
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
887864C2E
MEDICARE BILLING NO.
NJ
Enumeration date
12/11/2006
Last updated
01/10/2011
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