Individual
DR. ILLY DOMINITZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1468 INGRAM ST, NORFOLK, VA 23551-2596
(757) 836-1685
(757) 836-1528
Mailing address
1468 INGRAM ST, NORFOLK, VA 23551-2596
(757) 836-1685
(757) 836-1528
Taxonomy
Speciality
Code
Description
License number
State
2083P0500X
Preventive Medicine/Occupational Environmental Medicine Physician
Primary
0101228195
VA
Other
Enumeration date
01/31/2007
Last updated
07/08/2007
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