Individual provider · Type 1 NPI
Christopher James Dominique, RPA-C
Surgical Physician Assistant · North Massapequa, NY
NPI number
1104083682
Active
Practice location
15 Marlboro Ave
North Massapequa, NY 11758-2429
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Surgical Physician Assistant Primary | 363AS0400X | 012547-1 (NY) |
Surgical Physician Assistant: Definition to come...
About NPI 1104083682
Christopher James Dominique, RPA-C's National Provider Identifier is 1104083682, issued on May 21, 2008. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in North Massapequa, NY. The record was last updated on May 21, 2008.