National Provider Identifier

Jacob Dominik, MD

Jacob Dominik, MD is listed in the NPPES registry with a primary specialty of Neurology Physician in Rochester, NY and a listed phone number of (585) 419-7948.

NPI 1629233861Rochester, NYNeurology Physician

Profile Overview

NPI
1629233861
Provider Type
Individual
Primary Specialty
Neurology Physician
Enumeration Date
July 28, 2008
Last Updated
September 13, 2022

Practice Location

  • 755 Jefferson RD
  • Ste 110
  • Rochester, NY 14623-3233

Phone: (585) 419-7948

Specialties

  • Neurology Physician (2084N0400X)
  • Neurology Physician (2084N0400X)
  • Sleep Medicine (Internal Medicine) Physician (207RS0012X)
  • Sleep Medicine (Psychiatry & Neurology) Physician (2084S0012X)
Full Record
NPI
1629233861
Entity Type
Individual
Last Name
Dominik
First Name
Jacob
Credential
MD
Mailing Street Address
755 Jefferson RD
Mailing Address Line 2
Ste 110
Mailing City
Rochester
Mailing State
NY
Mailing ZIP Code
14623-3233
Mailing Country
US
Mailing Phone
(585) 419-7948
Mailing Fax
(585) 385-6071
Practice Street Address
755 Jefferson RD
Practice Address Line 2
Ste 110
Practice City
Rochester
Practice State
NY
Practice ZIP Code
14623-3233
Practice Country
US
Practice Phone
(585) 419-7948
Practice Fax
(585) 385-6071
Enumeration Date
July 28, 2008
Last Updated
September 13, 2022
Sex
Male
Sole Proprietor
No
Certification Date
September 13, 2022
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Neurology Physician (2084N0400X), Neurology Physician (2084N0400X), Sleep Medicine (Internal Medicine) Physician (207RS0012X), Sleep Medicine (Psychiatry & Neurology) Physician (2084S0012X)
Other Identifiers
ENROLLED (IA), 03400199 (NY), ENROLLED (MN), P010257520 (NY, Excellus), P00804268 (MN, Medicare - Railroad)