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NPI Code Detail

MEDICARE: MS. HELAINE DOMINGUEZ RN

MEDICARE: MS. HELAINE DOMINGUEZ RN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered Nurse199565-1NY

General Provider Information

NPI Number : 1316222789
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. HELAINE DOMINGUEZ RN
Provider Business Mailing Address
First Line : 35 RIVER DR S
Second Line : #507
City : JERSEY CITY
State : NJ
Zip : 07310-3798
Country : US
Telephone Number : 201-360-3612
Fax Number :
Provider Business Practice Location Address
First Line : 1358 56TH ST
Second Line :
City : BROOKLYN
State : NY
Zip : 11219-4616
Country : US
Telephone Number : 718-851-7100
Fax Number : 718-437-6397
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/18/2011
Last Update Date : 10/18/2011

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