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Search › Pennsylvania › 363A00000X

Dominique Etienne, PA-C

NPI 1750710315 · on the registry since 2013

Practice

Address
1603 E Wadsworth Ave
Philadelphia, PA 19150
Phone
(215) 242-2439
Fax
(215) 242-2596
Organisation at this address
Penrose Medical Center, Inc
Inferred from a shared address, not stated in the registry.
Clinicians at this address
2

Registry record

Primary taxonomy
363A00000X
363A00000X
Also registered as
363A00000X
Licence states on file
PA, NJ
From the registry's licence fields, which are often incomplete.
Sex
Female
Record last updated
2015-06-05

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Pennsylvania