Individual
MARK A. DOMINGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA. PSYA
Contact information
Practice address
800 CATALPA AVE, TEANECK, NJ 07666
(201) 641-5648
(201) 440-8580
Mailing address
250 EUCLID AVE, RIDGEFIELD PK, NJ 07660
(201) 641-5648
(201) 440-8580
Taxonomy
Speciality
Code
Description
License number
State
102L00000X
Psychoanalyst
Primary
—
—
Other
Enumeration date
06/03/2021
Last updated
06/03/2021
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