Dominguez, Ileana

Dominguez, Ileana is an individual health care provider with primary practice located at 6000 Park Ave , West New York NJ 07093-3716. She recently has only one registered license in Pharmacy Service Providers / Pharmacist, which is considered as her primary health care specialty. Dominguez, Ileana can be contacted via phone (201) 868-5005.

Contact Information

Primary practice address
6000 Park Ave West New York NJ 07093-3716
Phone: (201) 868-5005
Fax: (201) 868-5974
Website:
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Health care specialties

SpecialtyCodeLicense #State
Pharmacy Service Providers / Pharmacist 183500000X 28RI02991400 New Jersey

Profile Details

NPI number 1598824310
LBN Legal business name Dominguez, Ileana
Credentials PHARM D.
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 7th, 2006
Last updated Sep 25th, 2018 - about 7 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 1598824310 NPPES
New Jersey MEDICAID 0547361

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