Individual provider · Type 1 NPI

Dominique Footman

Student in an Organized Health Care Education/Training Program · Bay Shore, NY

NPI number 1497577662 Active

Practice location

1444 5th Ave
Bay Shore, NY 11706-4147

Call (631) 647-3100 Map

Mailing address

790 Park Ave
Huntington, NY 11743-4516

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1497577662

Dominique Footman's National Provider Identifier is 1497577662, issued on Oct 29, 2024. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Bay Shore, NY. The record was last updated on Oct 29, 2024.