Provider Demographics
NPI:1730762063
Name:DOMONICS, KATALIN
Entity type:Individual
Prefix:
First Name:KATALIN
Middle Name:
Last Name:DOMONICS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:99 FINNEGAN LN
Mailing Address - Street 2:
Mailing Address - City:KENDALL PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:08824-1644
Mailing Address - Country:US
Mailing Address - Phone:732-720-9510
Mailing Address - Fax:
Practice Address - Street 1:99 FINNEGAN LN
Practice Address - Street 2:
Practice Address - City:KENDALL PARK
Practice Address - State:NJ
Practice Address - Zip Code:08824-1644
Practice Address - Country:US
Practice Address - Phone:732-720-9510
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-04
Last Update Date:2021-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY768392163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse