Provider Demographics
NPI:1982616629
Name:DOMB, JANE ALICE (MD)
Entity type:Individual
Prefix:DR
First Name:JANE
Middle Name:ALICE
Last Name:DOMB
Suffix:
Gender:
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:5001 MAYFIELD RD STE 114
Mailing Address - Street 2:
Mailing Address - City:LYNDHURST
Mailing Address - State:OH
Mailing Address - Zip Code:44124-2608
Mailing Address - Country:US
Mailing Address - Phone:216-327-0294
Mailing Address - Fax:216-304-2379
Practice Address - Street 1:5001 MAYFIELD RD STE 114
Practice Address - Street 2:
Practice Address - City:LYNDHURST
Practice Address - State:OH
Practice Address - Zip Code:44124-2608
Practice Address - Country:US
Practice Address - Phone:216-327-0294
Practice Address - Fax:216-304-2379
Is Sole Proprietor?:No
Enumeration Date:2006-08-12
Last Update Date:2025-04-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH590352084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry