IndividualActive
Carlos Dominguez Gonzalez
NPI 1104600501 · Genetic Counselor (M.S.) · Philadelphia, PA
Provider details
- NPI number
- 1104600501
- Entity type
- Individual
- Primary specialty
- Genetic Counselor (M.S.)Other Service Providers
- Sex
- Male
- Sole proprietor
- Yes
- License
- PGC000165 (PA)
Practice location
3401 Civic Center Blvd
Philadelphia, PA 19104-4319
Phone: (215) 590-1719
Fax: (215) 590-1771
Mailing address
3401 Civic Center Blvd
Philadelphia, PA 19104-4319
Registry dates
- Enumerated
- 2023-08-24
- Last updated
- 2023-08-24
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.