Dominguez, Maritza
Dominguez, Maritza is an individual health care provider with primary practice located at 101 S Bergen Place , Freeport NY 11520. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Adult Health, which is considered as her primary health care specialty. Dominguez, Maritza can be contacted via phone (516) 623-3600.Contact Information
Primary practice address
101 S Bergen Place
Freeport NY 11520
Phone: (516) 623-3600
Fax: (516) 623-9191
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Adult Health | 363LA2200X | F303551 | New York |
Profile Details
| NPI number | 1457339202 |
|---|---|
| LBN Legal business name | Dominguez, Maritza |
| Credentials | Adult Nurse Practitioner (ANP) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 3rd, 2006 |
| Last updated | Apr 20th, 2015 - about 9 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 | 1457339202 | NPPES |
| New York | MEDICAID | 02481836 |
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