Individual
MICHELLE DOMINGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
575 STATE ROUTE 28 STE 2108, RARITAN, NJ 08869-1354
(973) 295-6335
(862) 204-3456
Mailing address
575 STATE ROUTE 28 STE 2108, RARITAN, NJ 08869-1354
(973) 295-6335
(862) 204-3456
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
09/19/2013
Last updated
10/11/2022
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