Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 26NJ00407000 | NJ |
NPI | 1003153529 |
---|---|
Provider Name | Eleanor C Dominguez-Curatolo |
First Address | Toms River, NJ 08754-4979 |
Second Address | Toms River, NJ 08753-6407 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/01/2013 |
Last Update Date | 04/01/2013 |