Elvita Genelus-Dominique, D.O, F.a.C.S, P.C

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

Legal business name

ELVITA GENELUS-DOMINIQUE, D.O, F.A.C.S, P.C

Practice address

5850 Catalpa Ave
Ridgewood, NY 11385-5028

Phone

(718) 821-1910

Fax

(718) 821-1125

NPI assigned

Mar 7, 2019

Organization subpart

No

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

Authorized official

Name

Dr. Elvita Genelus-Dominique, DO

Title

Owner

Phone

(516) 721-5168

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1551916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1551916800000",
    "number": "1912465980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "628 LENORE LN",
            "city": "ELMONT",
            "state": "NY",
            "postal_code": "110034526",
            "telephone_number": "516-721-5168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5850 CATALPA AVE",
            "city": "RIDGEWOOD",
            "state": "NY",
            "postal_code": "113855028",
            "telephone_number": "718-821-1910",
            "fax_number": "718-821-1125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELVITA GENELUS-DOMINIQUE, D.O, F.A.C.S, P.C",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-07",
        "last_updated": "2019-03-07",
        "status": "A",
        "authorized_official_last_name": "GENELUS-DOMINIQUE",
        "authorized_official_first_name": "ELVITA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "516-721-5168",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03244057",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mina Eid
• Amr Samy Elbegrmi, PT, DPT
• Randa Elgamal, OTR/L
• Ellahi Drugs Inc
• Ellahi Drugs Inc
• Emmaus Center
• Suzanne Eng, MA, ATR-BC, LCAT
• Vivien Ying Eng, L.AC.
• Brenda Lynn Enriquez, LMHC
• Michelle Enriquez

• Surgery Physician in Ridgewood, NY
• Providers in Ridgewood, NY by specialty
• Surgery Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2019; 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.