Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 46843 | WI |
Y | 207VX0000X | Obstetrician | 01054947A | IN |
NPI | 1083671663 |
---|---|
Provider Name | Dr. Dominique L Gariti |
First Address | Newburgh, IN 47630-8940 |
Second Address | Newburgh, IN 47630-8940 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/04/2006 |
Last Update Date | 22/05/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
I10778 | (02) |