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

Mrs. Tyesha Dominique

Individual provider Physician Assistant · NPI 1376714139

Mrs. Tyesha Dominique is a Physician Assistant in New York, New York. Licensed in New York. Registered with an NPI since 2008.

Licensed in
NY
In the registry since
2008

Practice location Address checks out

312 E 94th St
New York, NY 10128-5604
Phone: (212) 423-3000
Fax: (212) 423-2920
Show map & directions

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

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 012331 (NY)

Record details

NPI number1376714139
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedMarch 19, 2008
Last updated in NPPESMarch 19, 2008

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