IndividualActive
Dominique Jan, MD
NPI 1790726982 · Pediatric Surgery Physician · Bronx, NY
Provider details
- NPI number
- 1790726982
- Entity type
- Individual
- Primary specialty
- Pediatric Surgery PhysicianAllopathic & Osteopathic Physicians
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- License
- 0024381 (NY)
Practice location
3355 Bainbridge Ave
Bronx, NY 10467-2801
Phone: (718) 920-7200
Fax: (718) 547-2929
Mailing address
3355 Bainbridge Ave
Bronx, NY 10467-2801
Registry dates
- Enumerated
- 2006-06-09
- Last updated
- 2012-01-19
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.