| Dominion Health Inc. | |
|
109 517th St Suite 25 Cheyenne WY 82001 | |
| (718) 436-0037 | |
| (718) 853-3269 |
| Full Name | Dominion Health Inc. |
|---|---|
| Speciality | Clinic/center |
| Location | 109 517th St, Cheyenne, Wyoming |
| Authorized Official Name and Position | Esther Phyllis Pellmutter (MD, CEO) |
| Authorized Official Contact | 7184360037 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dominion Health Inc. 5001a 15th Ave. Brooklyn NY 11219 Ph: (718) 436-0037 | Dominion Health Inc. 109 517th St Suite 25 Cheyenne WY 82001 Ph: (718) 436-0037 |
| NPI Number | 1508162785 |
|---|---|
| Provider Enumeration Date | 02/04/2011 |
| Last Update Date | 02/04/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508162785 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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