Individual
DR. ELVITA GENELUS-DOMINIQUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O
Contact information
Practice address
21 READE PL STE 3100, POUGHKEEPSIE, NY 12601
(845) 214-1800
(845) 214-1818
Mailing address
628 LENORE LN, ELMONT, NY 11003-4526
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
253246
NY
2086S0102X
Surgical Critical Care Physician
253246
NY
2086S0127X
Trauma Surgery Physician
253246
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03244057
—
NY
Enumeration date
02/02/2009
Last updated
10/25/2018
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