Jessica Dominguez (NPI# 1407176209, PAC ID# 3072733120) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is CLINICAL SOCIAL WORKER.
| Nation Provider ID (NPI) | 1407176209 |
| PAC ID by PECOS | 3072733120 |
| Professional Enrollment ID | I20141013001672 |
| Full Name | Jessica Dominguez |
| Organization Legal Name | PSCH INC |
| Address |
800 Northern Blvd Great Neck NY 11021-5340 |
| Phone Number | 5168299666 |
| Gender | F |
| Graduation Year | 2009 |
| Primary Specialty | CLINICAL SOCIAL WORKER |
| Group Practice PAC ID | 0749179570 |
| Number of Group Practice Members | 8 |
| Accepts Medicare Assignment | M |
| Address | Phone | Organization |
|---|---|---|
| 800 Northern Blvd, Great Neck, NY 11021-5340 | 5168299666 | PSCH INC |
| Organization Legal Name | PSCH INC |
| Physicians | 10 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Gloria Wright | Clinical Social Worker | Psch Inc | 800 Northern Blvd, Great Neck, NY 11021-5340 |
| Mindy E Prager | Psychiatry | Psch Inc | 3600 Route 112, Coram, NY 11727-4116 |
| Qiuxia M Lan | Psychiatry | Psch Inc | 800 Northern Blvd, Great Neck, NY 11021-5340 |
| Christine N Edmondson | Nurse Practitioner | Psch Inc | 11 Route 111, Smithtown, NY 11787-3754 |
| Reddy Bezwada | Psychiatry | Psch Inc | 800 Northern Blvd, Great Neck, NY 11021-5340 |
| Oanghkarjit Buttar | Psychiatry | Psch Inc | 800 Northern Blvd, Great Neck, NY 11021-5340 |
| Kim D Axelrad | Nurse Practitioner | Psch Inc | 800 Northern Blvd, Great Neck, NY 11021-5340 |
| Ashvin Doshi | Psychiatry | Psch Inc | 800 Northern Blvd, Great Neck, NY 11021-5340 |
| Amy Platt | Clinical Social Worker | Psch Inc | 800 Northern Blvd, Great Neck, NY 11021-5340 |
| Street Address |
800 NORTHERN BLVD |
| City | GREAT NECK |
| State | NY |
| Zip | 11021-5340 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Gloria Wright | Clinical Social Worker | Psch Inc | 800 Northern Blvd, Great Neck, NY 11021-5340 |
| Qiuxia M Lan | Psychiatry | Psch Inc | 800 Northern Blvd, Great Neck, NY 11021-5340 |
| Reddy Bezwada | Psychiatry | Psch Inc | 800 Northern Blvd, Great Neck, NY 11021-5340 |
| Oanghkarjit Buttar | Psychiatry | Psch Inc | 800 Northern Blvd, Great Neck, NY 11021-5340 |
| Maria R Bernstein | Nurse Practitioner | North Shore-lij Medical PC | 800 Northern Blvd, Suite 5, Great Neck, NY 11021-5314 |
| Kim D Axelrad | Nurse Practitioner | Psch Inc | 800 Northern Blvd, Great Neck, NY 11021-5340 |
| Ashvin Doshi | Psychiatry | Psch Inc | 800 Northern Blvd, Great Neck, NY 11021-5340 |
| Amy Platt | Clinical Social Worker | Psch Inc | 800 Northern Blvd, Great Neck, NY 11021-5340 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Victor J Defazio | Psychologist, Clinical | 10 Grave Ave, Suite 9, Great Neck, NY 11021 | |
| Philip M Ninan | Psychiatry | 935 Northern Boulevard, Suite 102, Great Neck, NY 11021 | |
| Jerelyn R Marcus | Optometry | 93 Bayview Ave, Great Neck, NY 11021-1015 | |
| Daniel Aryeh | Physical Therapy | 200 Middle Neck Rd, Suite H, Great Neck, NY 11021-1107 | |
| Helen Beegel | Clinical Social Worker | 160 Middle Neck Rd, Apt 3b, Great Neck, NY 11021-1207 | |
| Rosalie L Feder | Clinical Social Worker | 134 Middleneck Rd, Great Neck, NY 11021-1224 | |
| Mitchell Siegel | Podiatry | 32 Maple Dr, Great Neck, NY 11021-1240 | |
| Eleonora Tamayeva | Optometry | Great Neck Optometrist PC | 146 Middle Neck Rd, Great Neck, NY 11021-1246 |
| Kioomars Moosazadeh | Physical Medicine and Rehabilitation | 140 Middle Neck Rd, Great Neck, NY 11021-1246 | |
| Ebrahim Sadighim | Internal Medicine | 138 Middle Neck Rd, Great Neck, NY 11021-1246 | |
| Find all physicians in zip 11021 | |||
| City | GREAT NECK |
| Zip Code | 11021 |
| Specialty | CLINICAL SOCIAL WORKER |
| City + Specialty | GREAT NECK + CLINICAL SOCIAL WORKER |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.