DR. KEVIN ANTHONY DOMINGOS PH.D. NPI 1770662173

NPI Information

NPI: 1770662173
Provider Name: DR. KEVIN ANTHONY DOMINGOS, PH.D.
Classification: Clinical Neuropsychologist - 103G00000X
Entity Type: Individual

PECOS Registration: Yes

Address:
1854 RIVER ST
BOSTON, MA
ZIP 02136
Phone: (617) 364-4465
Get Directions

DR. Kevin Anthony Domingos, PH.D. is a clinical neuropsychologist in Boston, MA. The provider is a clinical psychologist who applies principles of assessment and intervention based upon the scientific study of human behavior as it relates to normal and abnormal functioning of the central nervous system. The specialty is dedicated to enhancing the understanding of brain-behavior relationships and the application of such knowledge to human problems. DR. Kevin Anthony Domingos, PH.D. NPI is 1770662173. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1854 RIVER ST
BOSTON, MA
ZIP 02136-419
Phone: (617) 364-4465
Fax: (617) 364-5425

The NPI 1770662173 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment.

The enumeration date for this NPI number is 11/4/2006 and was last updated on 7/8/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	103G00000X	Clinical Neuropsychologist		6878	MASSACHUSETTS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	0524689	MEDICAID	MASSACHUSETTS
2	W50026	MEDICARE ID-TYPE UNSPECIFIED	MASSACHUSETTS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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