Individual
ANNA DOMONT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1809 NOSTRAND AVE, BROOKLYN, NY 11226-7181
(718) 251-2244
(718) 421-4774
Mailing address
108-05 FLATLANDS AVE, BROOKLYN, NY 11236-4632
(718) 251-2244
(718) 421-4774
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
217804
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
217804
217804
NY
Enumeration date
10/15/2009
Last updated
10/15/2009
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