Provider Demographics
NPI:1043535719
Name:OGNIBENE, DOMINICK (RPH)
Entity Type:Individual
Prefix:MR
First Name:DOMINICK
Middle Name:
Last Name:OGNIBENE
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:407 POWERS FERRY RD
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27519-1508
Mailing Address - Country:US
Mailing Address - Phone:919-267-6573
Mailing Address - Fax:
Practice Address - Street 1:407 POWERS FERRY RD
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27519-1508
Practice Address - Country:US
Practice Address - Phone:919-267-6573
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-06
Last Update Date:2010-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC18194183500000X
NY040267183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist