Individual
MR. BOGNAY DURY DOMANAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LICENSED PT
Contact information
Practice address
4012 80TH ST, ELMHURST, NY 11373-1234
(718) 426-9595
(718) 426-2729
Mailing address
4012 80TH ST, ELMHURST, NY 11373-1234
(718) 426-9595
(718) 426-2729
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
025921-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02692708
—
NY
Enumeration date
05/31/2006
Last updated
01/22/2015
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