Individual
DOMINIQUE DEMATTIES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGNP
Contact information
Practice address
1000 E GENESEE ST, SYRACUSE, NY 13210-1892
(315) 471-8388
Mailing address
1000 E GENESEE ST, SYRACUSE, NY 13210-1892
(315) 471-8388
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
311889
NY
363LG0600X
Gerontology Nurse Practitioner
311889
NY
Other
Enumeration date
07/10/2024
Last updated
07/10/2024
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