Provider Demographics
NPI:1447502588
Name:DOMINGO, MARIA ELOISA SOLOMON (MD)
Entity type:Individual
Prefix:
First Name:MARIA ELOISA
Middle Name:SOLOMON
Last Name:DOMINGO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 HOSPITAL PLZ
Mailing Address - Street 2:APT 301
Mailing Address - City:PATERSON
Mailing Address - State:NJ
Mailing Address - Zip Code:07503-3072
Mailing Address - Country:US
Mailing Address - Phone:916-833-8745
Mailing Address - Fax:
Practice Address - Street 1:200 HOSPITAL PLZ
Practice Address - Street 2:APT 301
Practice Address - City:PATERSON
Practice Address - State:NJ
Practice Address - Zip Code:07503-3072
Practice Address - Country:US
Practice Address - Phone:916-833-8745
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-14
Last Update Date:2021-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program