Vanessa Dominique

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

2023000070 Issued in NY

Practice address

152 North Ocean Avenue
Patchogue, NY 11772

Phone

(631) 730-1189

NPI assigned

Nov 13, 2023

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1699833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699833600000",
    "number": "1184498917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "73 SUBURBAN AVE",
            "city": "DEER PARK",
            "state": "NY",
            "postal_code": "117296709",
            "telephone_number": "631-745-2508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "152 NORTH OCEAN AVENUE",
            "city": "PATCHOGUE",
            "state": "NY",
            "postal_code": "11772",
            "telephone_number": "631-730-1189"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2500 Nesconset Hwy",
            "address_purpose": "LOCATION",
            "city": "Stony Brook",
            "state": "NY",
            "postal_code": "117902555",
            "country_code": "US",
            "telephone_number": "631-751-5550",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOMINIQUE",
        "first_name": "VANESSA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-13",
        "last_updated": "2023-11-13",
        "certification_date": "2023-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "2023000070",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Discoveries Therapy LCSW, P.C.
• Amy C. Dittler, PMHNP-BC
• Nicole Marie Divirgilio, PT
• DME Medical Supplies Inc.
• Daphnie Doirin, SLP-CCC
• Mara Dooley, NP
• Wendy Doroski, NP
• Kyle James Dorr, RN
• Lisa M Doscher, R.N.
• Christine Marie Doucet, M.D.

• Family Nurse Practitioner in Patchogue, NY
• Providers in Patchogue, NY by specialty
• Family Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.