Individual
PETER DOMAOAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A. -C
Contact information
Practice address
170 WILLIAM ST, NEW YORK, NY 10038-2612
(212) 312-5000
Mailing address
170 WILLIAM ST, NEW YORK, NY 10038-2612
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
019164
NY
Other
Enumeration date
10/05/2015
Last updated
09/19/2022
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