MS. MARITZA DOMINGUEZ (NPI# 1457339202) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457339202 |
| Entity Type | Individual |
| Full Name | MS. MARITZA DOMINGUEZ |
| Credential | ANP |
| Practice Address |
101 S Bergen Place Freeport NY 11520 |
| Mailing Address |
380 Nassau Rd Long Island Fqhc, Inc. Roosevelt NY 11575-1343 |
| Practice Telephone | 5166233600 |
| Practice Fax Number | 5166239191 |
| Mailing Telephone | 5165718600 |
| Enumeration Date | 2006-01-03 |
| Last Update Date | 2015-04-20 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
F303551 | NY | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 02481836 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093886558 | Maritza Dominguez | Dentist | B-3 Cornwall Dr., East Brunswick, NJ 08816 | 2006-11-13 |
| 1598243826 | Maritza Dominguez | Case Manager/Care Coordinator | 1319 Saul Rd, Sunnyside, WA 98944-2300 | 2018-07-30 |
| 1679018808 | Maritza Dominguez | Counselor | 222 N Mountain Ave Ste 110b, Upland, CA 91786 | 2016-12-26 |
| 1124251475 | Maritza Dominguez | Physical Therapist | 7430 Remcon Cir, El Paso, TX 79912-3514 | 2009-09-02 |
| Street Address |
101 S BERGEN PLACE |
| City | FREEPORT |
| State | NY |
| Zip Code | 11520 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881157154 | Barbara Chillemi | Registered Nurse | 56 Mackay Place, Freeport, NY 11520 | 2019-04-12 |
| 1588171631 | Lisa Frank | Nurse Practitioner | 150 Buffalo Ave, Freeport, NY 11520 | 2018-01-10 |
| 1447775838 | Julner Quettant Jr. | Physical Therapist | 63 St Marks Ave, Freeport, NY 11520 | 2017-08-07 |
| 1679003933 | Candice A R Greene | Speech-Language Pathologist | 12 Summers Place, Freeport, NY 11520 | 2017-06-19 |
| 1700310331 | Samantha Edwards | Psychologist | 6 Delisle Avenue, Freeport, NY 11520 | 2017-04-20 |
| 1275073769 | Dorothea Geiger | Behavior Technician | 90 Hillside Ave, Freeport, NY 11520 | 2017-03-02 |
| 1477092575 | Maryhaven Center of Hope,inc | Substance Abuse Rehabilitation Facility | 150 Buffalo Avenue, Freeport, NY 11520 | 2017-02-22 |
| 1861849135 | Daniel Lora | Acupuncturist | 140 Parsons Ave, Freeport, NY 11520 | 2016-05-17 |
| 1326413790 | Beatrice Jeanty | Registered Nurse | 619 South Long Beach Ave., Freeport, NY 11520 | 2015-12-10 |
| 1134505548 | Maria A. Meek | Nurse Practitioner | 334, West Merrick Rd., Freeport., NY 11520 | 2015-08-07 |
| Find all providers in zip 11520 | ||||
| Taxonomy Code | 363LA2200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Adult Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205448115 | Charisse Grice | Nurse Practitioner | 123 Dehnhoff Ave, Freeport, NY 11520-2304 | 2020-08-21 |
| 1588171631 | Lisa Frank | Nurse Practitioner | 150 Buffalo Ave, Freeport, NY 11520 | 2018-01-10 |
| 1356706444 | Jennifer Marie O'neill | Nurse Practitioner | 77 W 2nd St, Freeport, NY 11520-5720 | 2015-12-16 |
| 1437556206 | Marlena Gallo | Nurse Practitioner | 155 W Merrick Rd Ste 101, Freeport, NY 11520-3743 | 2014-11-21 |
| 1326308776 | Alicia A Tate | Nurse Practitioner | 119 Jay Street, Freeport, NY 11520 | 2012-05-19 |
| 1629342514 | Jean Anne Georges | Nurse Practitioner | 200 W 2nd St Fl 3, Freeport, TX 77541-5773 | 2012-02-24 |
| 1275847550 | Marsha Patrice Drummond | Nurse Practitioner | 32 Laurette Ln, Freeport, NY 11520-5737 | 2010-07-29 |
| 1689897944 | Lisa Carmella Williams | Nurse Practitioner | 39 Porterfield Pl, Freeport, NY 11520-3340 | 2007-04-11 |
| 1225552409 | Cindy Guzman | Nurse Practitioner | 55 N Main St, Freeport, NY 11520-2243 | 2017-07-31 |
| 1679023592 | Maureen Mohini Kallman | Nurse Practitioner | 33 N Ocean Ave, Freeport, NY 11520-3049 | 2016-10-04 |
| Find all providers in FREEPORT | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.