Provider Demographics
NPI:1275408502
Name:DOMINGUEZ ALONSO, DEBORA
Entity type:Individual
Prefix:
First Name:DEBORA
Middle Name:
Last Name:DOMINGUEZ ALONSO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:DEBORAH
Other - Middle Name:
Other - Last Name:DOMINGUEZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:123 LINDEN BLVD APT 16T
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11226-9739
Mailing Address - Country:US
Mailing Address - Phone:323-362-3440
Mailing Address - Fax:
Practice Address - Street 1:123 LINDEN BLVD APT 16T
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11226-9739
Practice Address - Country:US
Practice Address - Phone:323-362-3440
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-07
Last Update Date:2025-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY171R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171R00000XOther Service ProvidersInterpreterGroup - Single Specialty