Dominguez, Gliceria
Dominguez, Gliceria is an individual health care provider with primary practice located at 10201 66Th Rd , Forest Hills NY 11375-2029. She recently has only one registered license in Allopathic & Osteopathic Physicians / Anesthesiology, which is considered as her primary health care specialty. Dominguez, Gliceria can be contacted via phone (718) 830-4090.Contact Information
Primary practice address
10201 66Th Rd
Forest Hills NY 11375-2029
Phone: (718) 830-4090
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Anesthesiology | 207L00000X | 153077 | New York |
Profile Details
| NPI number | 1154327179 |
|---|---|
| LBN Legal business name | Dominguez, Gliceria |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 23rd, 2005 |
| Last updated | Nov 3rd, 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1154327179 | NPPES |
| New York | MEDICAID | 00873390 |
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