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1184498917
VANESSA DOMINIQUE
PATCHOGUE, NY
NPI
1184498917
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: NY 2023000070)
Enumeration Date
2023-11-13
Last Update Date
2023-11-13
Business Address
VANESSA DOMINIQUE
152 NORTH OCEAN AVENUE
PATCHOGUE, NY 11772
Phone number: 631-730-1189
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Mailing Address
VANESSA DOMINIQUE
73 SUBURBAN AVE
DEER PARK, NY 11729-6709
Phone number: 631-745-2508
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