THOMAS M DOMANICK (NPI# 1629012661) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1629012661 |
Entity Type | Individual |
Full Name | THOMAS M DOMANICK |
Credential | D.P,M, |
Practice Address |
1825 Barnum Ave Stratford CT 06614-5333 |
Mailing Address |
2660 Main St Suite 216 Bridgeport CT 06606-5369 |
Practice Telephone | 2033771777 |
Mailing Telephone | 2033771777 |
Enumeration Date | 2006-06-16 |
Last Update Date | 2015-01-07 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 213EP1101X |
Podiatrist Specialization: Primary Podiatric Medicine |
P00289 | CT | Podiatric Medicine & Surgery Service Providers |
N | 213ES0131X |
Podiatrist Specialization: Foot Surgery |
P00289 | CT | Podiatric Medicine & Surgery Service Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
CT | MEDICAID DME | 004144309 | 01 |
CT | HEALTH NET | 0V2746 | 01 |
CT | OXFORD | ZS701 | 01 |
CT | ANTHEM BC/BS | 030000289CT02 | 01 |
CT | HEALTH NET SMART CHOICE | 0V2746 | 01 |
CT | 004051868 | 05 | |
CT | AETNA | 0071014 | 01 |
Street Address |
1825 BARNUM AVE |
City | STRATFORD |
State | CT |
Zip Code | 06614-5333 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1376931311 | St. Vincent's Multispecialty Group | Durable Medical Equipment & Medical Supplies | 1825 Barnum Ave, Stratford, CT 06614-5333 | 2014-12-29 |
1265747323 | Maria Delvecchio Valerian | Social Worker | 1825 Barnum Ave, Suite 304, Stratford, CT 06614-5333 | 2010-08-13 |
1457662181 | Carla M Monteiro | Dentist | 1825 Barnum Ave, Suite 303, Stratford, CT 06614-5333 | 2010-06-28 |
1962641951 | Joyce A Evon | Counselor | 1825 Barnum Ave, #304, Stratford, CT 06614-5333 | 2009-02-13 |
1235316597 | Thomas M Domanick Dpm | Surgery | 1825 Barnum Ave, Stratford, CT 06614-5333 | 2008-01-29 |
1972647600 | Pulmonary Rehabilitation Associates, LLC | Internal Medicine | 1825 Barnum Ave, Suite 203, Stratford, CT 06614-5333 | 2007-02-16 |
1134298748 | Alan Goldberg | Dentist | 1825 Barnum Ave, Suite 303, Stratford, CT 06614-5333 | 2006-11-07 |
1588733133 | Elke W Cheung | Dentist | 1825 Barnum Ave, Suite 303, Stratford, CT 06614-5333 | 2006-11-07 |
1629147277 | Andrew M Marcus | Dentist | 1825 Barnum Ave, Suite 303, Stratford, CT 06614-5333 | 2006-11-07 |
1447329909 | John Tanzilli | Dentist | 1825 Barnum Ave, Suite 303, Stratford, CT 06614-5333 | 2006-11-07 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1588139604 | David A Crosby | Physician Assistant | 125 Pumpkin Ground Road, Stratford, CT 06614 | 2018-10-04 |
1710489232 | Karen Marie Laconte | Naturopath | 720 Hilltop Dr, Stratford, CT 06614 | 2018-02-28 |
1972024693 | Amanda Wilson | Social Worker | 60 Edmund Street, Stratford, CT 06614 | 2017-07-03 |
1558801423 | Kristine Lynn Conlan | Physical Therapist | 55 Pasadena Ave., Stratford, CT 06614 | 2017-02-27 |
1811440258 | Seokwon Kwon | Dentist | 320 Boston Ave, Stratford, CT 06614 | 2016-08-02 |
1093176141 | Kathleen G Domek | Technician/Technologist | 150 Barnum Avenue Cut Off, Stratford, CT 06614 | 2016-03-17 |
1417328634 | Kelley Machado | Social Worker | 2127 Nichols Ave, Stratford, CT 06614 | 2015-10-14 |
1043629553 | Jennifer Woods-mesquita | Social Worker | 125 Greenlawn Ave, Stratford, CT 06614 | 2014-08-08 |
1437564010 | Jose R. Pacheco | Obstetrics & Gynecology | 120 Brightwood Ave, Stratford, CT 06614 | 2014-06-23 |
1740612829 | Stanley Brovender | General Practice | 773b Pontiac Lane, Stratford, CT 06614 | 2013-07-31 |
Find all providers in zip 06614 |
Taxonomy Code | 213EP1101X |
Grouping | Podiatric Medicine & Surgery Service Providers |
Classification | Podiatrist |
Specialization | Primary Podiatric Medicine |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1609354372 | Riverside Podiatry,llc | Podiatrist | 11 Westridge Dr, Avon, CT 06001-3648 | 2018-08-03 |
1104236199 | Sean Wayne Lazarus D.p.m. LLC | Podiatrist | 764 Campelle Ave, Unitg, West Haven, CT 06516-3786 | 2014-04-30 |
1588957872 | Mt Podiatry, LLC | Podiatrist | 1021 Asylum Ave, Apt 407, Hartford, CT 06105-2436 | 2011-05-19 |
1497817118 | Michael Connor | Podiatrist | 27 Danbury Rd Fl 3, Wilton, CT 06897-4405 | 2006-12-16 |
1659320711 | Todd Allen Bell | Podiatrist | 57 Jolley Dr, Unit A, Bloomfield, CT 06002-3062 | 2006-05-08 |
1114928074 | Michael Jospeh Ackley | Podiatrist | 714 S Main St, Cheshire, CT 06410-3448 | 2005-08-02 |
1831194042 | Karana Marie Pierre | Podiatrist | 471 Barnum Ave, Bridgeport, CT 06608-2409 | 2005-06-15 |
1205479243 | Nili T Harpaz | Podiatrist | 309 Seaside Ave, Milford, CT 06460-4625 | 2019-10-22 |
1205489077 | St Vincents Multispecialty Group Inc | Podiatrist | 2409 Main St, Bridgeport, CT 06606-5324 | 2019-07-22 |
1215271713 | Primed, LLC | Podiatrist | 4699 Main St, Suite 211, Bridgeport, CT 06606-1830 | 2012-11-21 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.