| Domi Healthcare Llc | |
|
7919 Kennedy Blvd North Bergen NJ 07047 | |
| (201) 351-3177 | |
| (201) 605-9345 |
| Full Name | Domi Healthcare Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 7919 Kennedy Blvd, North Bergen, New Jersey |
| Authorized Official Name and Position | Jonathan Manuel Dominguez (OWNER) |
| Authorized Official Contact | 2016581911 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Domi Healthcare Llc 7919 Kennedy Blvd North Bergen NJ 07047 Ph: (201) 351-3177 | Domi Healthcare Llc 7919 Kennedy Blvd North Bergen NJ 07047 Ph: (201) 351-3177 |
| NPI Number | 1548891385 |
|---|---|
| Provider Enumeration Date | 01/30/2020 |
| Last Update Date | 01/18/2024 |
| Medicare PECOS PAC ID | 9931551355 |
|---|---|
| Medicare Enrollment ID | O20240122000432 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548891385 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Jonathan Manuel Dominguez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1376923755 PECOS PAC ID: 4688914765 Enrollment ID: I20200113000028 |
| Provider Name | Caridad Manuela Iparraguirre |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1700383924 PECOS PAC ID: 1658773171 Enrollment ID: I20210707000604 |
| Provider Name | Jose Antonio Badia |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740926161 PECOS PAC ID: 1951782747 Enrollment ID: I20220726001370 |
| Provider Name | Jocelyn Angela Ortiz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801509062 PECOS PAC ID: 5092188706 Enrollment ID: I20230228001835 |
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