Individual
MRS. GRACE RITA R DOMINGO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
530 1ST AVE # SKI-9R, LEON H CHARNEY DIVISION OF CARDIOLOGY, NEW YORK, NY 10016-6402
(212) 263-8177
(212) 263-3988
Mailing address
530 1ST AVE, SKI-9R, NEW YORK, NY 10016-6497
(212) 263-8177
(212) 263-3988
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
334785-1
NY
Other
Enumeration date
11/30/2006
Last updated
07/12/2011
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