Dominique, Patricia
Dominique, Patricia is an individual health care provider with primary practice located at 801 Massachusetts Ave Crosstown 2Nd Floor, Boston MA 02118-2605. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Gerontology, which is considered as her primary health care specialty. Dominique, Patricia can be contacted via phone (617) 414-4376.Contact Information
Primary practice address
801 Massachusetts Ave Crosstown 2Nd Floor
Boston MA 02118-2605
Phone: (617) 414-4376
Fax: (617) 414-4676
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Gerontology | 363LG0600X | RN268854 | Massachusetts |
Profile Details
| NPI number | 1760914386 |
|---|---|
| LBN Legal business name | Dominique, Patricia |
| Credentials | Nurse Practitioner (NP) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 2nd, 2017 |
| Last updated | Sep 28th, 2017 - about 9 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1760914386 | NPPES |
| Massachusetts | MEDICAID | 110122168A |
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