Elvita Genelus-Dominique, D.o, F.a.c.s, P.c

NPI #1912465980 in Ridgewood, New York

Provider Information

NPI Number: 1912465980
Entity Type: Organization
Organization Name: Elvita Genelus-Dominique, D.o, F.a.c.s, P.c
Primary Specialty: Surgery
Enumeration Date: Mar 7, 2019
Last Updated: Mar 7, 2019

Practice Location

Address: 5850 CATALPA AVE
City: Ridgewood
State: New York
ZIP Code: 11385-5028
Phone: (718) 821-1910

Authorized Official

Name: DR. ELVITA GENELUS-DOMINIQUE, DO
Title: OWNER
Phone: (516) 721-5168

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Surgery	208600000X	Primary

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