Individual provider · Type 1 NPI

Edgar Antonio Domenech

Student in an Organized Health Care Education/Training Program · Fayetteville, NC

NPI number 1770191629 Active

Practice location

1638 Owen Drive
Fayetteville, NC 28304

Call (910) 615-4000 Map

Other practice locations

  • Phsu, 388 Zona Industrial Reparada 2, Ponce, PR 00716-7004 · (787) 840-2575

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 1770191629

Edgar Antonio Domenech's National Provider Identifier is 1770191629, issued on Jul 16, 2020. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Fayetteville, NC. The record was last updated on Apr 8, 2023.