Doctor Name: | DORIS DOMINGUE |
NPI Number: | 1750695151 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | ARDMS |
License Number: | 4066 |
Business Practice Address: | 130 Grasshopper Ln Greentown, PA - 184267449 |
Business Phone Number: | 5708143009 |
Business Fax Number: | |
Mailing Address: | 130 Grasshopper Ln, GREENTOWN |
State: | PA |
Postal Code: | 184267449 |
Phone Number: | 5708143009 |
Fax Number: | |
NPI Enumeration Date: | 07/28/2010 |
NPI Last Update Date: | 07/28/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2471S1302X |
License Number: | 4066 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PA |
Taxonomy Type: | Technologists, Technicians & Other Technical Service Providers |
Taxonomy Classification: | Radiologic Technologist |
Taxonomy Specialization: | Sonography |
Taxonomy Definition: |