Individual
MR. DAVID BUCAO DOMINGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
3505 VETERANS MEMORIAL HWY., RONKONKOMA, NY 11779
(631) 676-7656
(631) 676-7648
Mailing address
3505 VETERANS MEMORIAL HWY., RONKONKOMA, NY 11779
(631) 676-7656
(631) 676-7648
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
F303626
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02662297
—
NY
Enumeration date
03/09/2007
Last updated
09/16/2011
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