THOMAS M DOMANICK


Address: 1825 Barnum Ave, Stratford, CT 06614-5333
Phone: 2033771777

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).

Provider Overview

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

Taxonomy

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

Other Provider Identifier

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

Office Location

Street Address 1825 BARNUM AVE
City STRATFORD
State CT
Zip Code 06614-5333

Providers in the same location

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
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Providers in the same zip code

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
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Taxonomy Information

Taxonomy Code 213EP1101X
Grouping Podiatric Medicine & Surgery Service Providers
Classification Podiatrist
Specialization Primary Podiatric Medicine

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and state

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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Competitor

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City STRATFORD
Zip Code 06614

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Dataset Information

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.

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