Provider Demographics
NPI:1952659625
Name:DOMINGUEZ ALMONTE, EDWIN A (MD)
Entity Type:Individual
Prefix:DR
First Name:EDWIN
Middle Name:A
Last Name:DOMINGUEZ ALMONTE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1345 RXR PLZ FL 13
Mailing Address - Street 2:
Mailing Address - City:UNIONDALE
Mailing Address - State:NY
Mailing Address - Zip Code:11556-1301
Mailing Address - Country:US
Mailing Address - Phone:516-453-0435
Mailing Address - Fax:646-846-3283
Practice Address - Street 1:388 E FORDHAM RD
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10458
Practice Address - Country:US
Practice Address - Phone:718-489-3553
Practice Address - Fax:718-489-3554
Is Sole Proprietor?:No
Enumeration Date:2012-08-28
Last Update Date:2019-07-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY290649207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine