Individual
NATALIE KATHERINE DOMANSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
200 S ORANGE AVE STE 180, LIVINGSTON, NJ 07039-5817
(973) 828-0128
Mailing address
1 DIAMOND HILL RD, BERKELEY HEIGHTS, NJ 07922-2104
(908) 273-4300
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
25MP00741900
NJ
363AS0400X
Surgical Physician Assistant
Primary
25MP00741900
NJ
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/28/2022
Last updated
12/16/2022
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