Berthony Domingue

Primary specialty

BusTaxonomy code 347B00000X

Practice address

2669 Fries Mill Rd
Williamstown, NJ 08094-3336

Phone

(973) 860-8552

NPI assigned

Apr 10, 2017

Sex

Male

Sole proprietor

Yes

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

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• A Family Fun Program LLC

  • Respite Care Camp
  • Williamstown, NJ
  • NPI 1124679360
  Authorized official Same address or phone

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

{
    "created_epoch": "1491782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491782400000",
    "number": "1245763846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2669 FRIES MILL RD",
            "city": "WILLIAMSTOWN",
            "state": "NJ",
            "postal_code": "080943336",
            "telephone_number": "973-860-8552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2669 FRIES MILL RD",
            "city": "WILLIAMSTOWN",
            "state": "NJ",
            "postal_code": "080943336",
            "telephone_number": "973-860-8552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMINGUE",
        "first_name": "BERTHONY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-04-10",
        "last_updated": "2017-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "347B00000X",
            "taxonomy_group": "",
            "desc": "Bus",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark Anthony Di Medio, DPM
• Salimatou Diallo
• Shade Dickson
• Dignipsych Health Services
• Lida E Dipalma
• Jennifer Drenchek, MA CCC-SLP/L
• Paige Colette Earley, NCC LPC LCADC ACS
• Brooke Alyssa Easley
• Michael Ebanks Jr., RRT
• Elite Home Healthcare Services LLC

• Bus in Williamstown, NJ
• Providers in Williamstown, NJ by specialty
• Bus in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2017; 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.