Domingos, Kevin Anthony

Domingos, Kevin Anthony is an sole proprietor health care provider with primary practice located at 1854 River St , Boston MA 02136-1419. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical Neuropsychologist, which is considered as his primary health care specialty. Domingos, Kevin Anthony can be contacted via phone (617) 364-4465.

Contact Information

Primary practice address
1854 River St Boston MA 02136-1419
Phone: (617) 364-4465
Fax: (617) 364-5425
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical Neuropsychologist 103G00000X 6878 Massachusetts

Profile Details

NPI number 1770662173
LBN Legal business name Domingos, Kevin Anthony
Credentials PH.D.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 4th, 2006
Last updated Jul 8th, 2007 - about 18 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 1770662173 NPPES
Massachusetts MEDICAID 0524689

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