Provider Demographics
NPI:1316740186
Name:DOMINGUEZ, ELBA
Entity type:Individual
Prefix:
First Name:ELBA
Middle Name:
Last Name:DOMINGUEZ
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:ELBA
Other - Middle Name:I
Other - Last Name:DOMINGUEZ CASTILLO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DOULA
Mailing Address - Street 1:235 E 117TH ST APT 4D
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10035-4828
Mailing Address - Country:US
Mailing Address - Phone:646-316-6514
Mailing Address - Fax:
Practice Address - Street 1:235 E 117TH ST APT 4D
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10035-4828
Practice Address - Country:US
Practice Address - Phone:646-316-6514
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-28
Last Update Date:2025-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula