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General NPI Number Information
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NPI Number | 1437446234
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Entity Type | Individual
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Provider Name | DOMINIKA DEPALMA PA
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Gender | Female
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Dates
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Enumeration Date | 06/30/2011
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Last Update Date | 01/08/2019
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Provider Practice Location Address
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Address Line | 34 34TH ST UNIT 5A
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City | BROOKLYN
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State | NY
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Zip | 11232
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Country | US
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Telephone | 267-841-7838
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Fax |
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Provider Business Mailing Address
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Address Line | 84 HILLVIEW AVE
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City | FRANKLIN PARK
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State | NJ
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Zip | 08823-1264
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Country | US
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Telephone | 908-240-3393
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 006872
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 25MP00274900
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License Number State | NJ
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Taxonomy #3
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 014827
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License Number State | NY
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