Individual
VANESSA DOMINGUES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10 GARIBALDI AVE, SUITE 34, NEWARK, NJ 07114-2110
(908) 247-5776
Mailing address
10 GARIBALDI AVE, NEWARK, NJ 07114-2110
(908) 247-5776
Taxonomy
Speciality
Code
Description
License number
State
237700000X
Hearing Instrument Specialist
Primary
25MG00133800
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
25MG00133800
STATE OF NEW JERSEY
NJ
Enumeration date
10/29/2014
Last updated
09/09/2016
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