Active NPI
Celine Marielle Domingo
- Physical Therapist
- New York, NY
National Provider Identifier
1497119309
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 38754
- Practice address
- 675 3Rd Ave
5TH Floor
New York, NY 10017-5704 - Phone
- (212) 922-1001
- NPI assigned
- Apr 6, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 38754 | NY | Primary |
Addresses
Primary practice location
675 3Rd Ave
5TH Floor
New York, NY 10017-5704
Mailing address
675 3Rd Ave # 5F
New York, NY 10017-5704
Phone (212) 922-1001
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 38754 | NY | MD | Sonography Specialist/Technologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1459900800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1626825600000",
"number": "1497119309",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "675 3RD AVE # 5F",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100175704",
"telephone_number": "212-922-1001"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "675 3RD AVE",
"address_2": "5TH FLOOR",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100175704",
"telephone_number": "212-922-1001"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOMINGO",
"first_name": "CELINE MARIELLE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-04-06",
"last_updated": "2021-07-21",
"certification_date": "2021-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "38754",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.