Domenico, Eugene

Domenico, Eugene is an individual health care provider with primary practice located at Market Street Bewley Building Suite #437, Lockport NY 14094. He recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Psychologist. Behavioral Health & Social Service Providers / Mental Health is his primary health care specialty. Domenico, Eugene can be contacted via phone (716) 438-2436.

Contact Information

Primary practice address
Market Street Bewley Building Suite #437 Lockport NY 14094
Phone: (716) 438-2436
Fax: (716) 438-2435
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 034738-1 New York
Behavioral Health & Social Service Providers / Clinical 1041C0700X 034738-1 New York
Behavioral Health & Social Service Providers / Psychologist 103T00000X 034738-1 New York

Profile Details

NPI number 1679608103
LBN Legal business name Domenico, Eugene
Credentials PHD LCSW
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 23rd, 2007
Last updated Dec 16th, 2009 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1679608103 NPPES
New York Other 00020255501 UNIVERA
New York Other 000511600005 UNIVERA

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