Individual
DEBORAH DOMINIC
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
314 S MANNING BLVD, ALBANY, NY 12208-1708
(518) 453-2273
Mailing address
314 S MANNING BLVD, ALBANY, NY 12208-1708
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
005867
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000410282001
BSNENY
—
05
—
005867
—
NY
Enumeration date
04/25/2006
Last updated
07/08/2007
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