Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dominique Footman

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1497577662

Dominique Footman is a Student in an Organized Health Care Education/Training Program in Bay Shore, New York. Licensed in New York. Registered with an NPI since 2024.

Licensed in
NY
In the registry since
2024

Practice location Address checks out

1444 5th Ave
Bay Shore, NY 11706-4147
Phone: (631) 647-3100
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Student in an Organized Health Care Education/Training Program (primary) Taxonomy 390200000X (NY)

Record details

NPI number1497577662
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedOctober 29, 2024
Last updated in NPPESOctober 29, 2024
Certification dateOctober 29, 2024

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