Dr. Domenick Braccia
Family Doctor Family Doctor - Addiction Medicine
1035 Virginia Dr
Fort Washington
, Pennsylvania 19034-3103
Dr. Domenick Braccia
Family Doctor Family Doctor - Addiction Medicine
1035 Virginia Dr
Fort Washington
, Pennsylvania 19034-3103
(267) 419-7710
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About
Features
Specialties
- Family Doctor
- Family Doctor - Addiction Medicine
Languages spoken
- English
Location
First Address
- Dr. Domenick Braccia
- 1035 Virginia Dr
- Fort Washington, PA
- Zip : 19034
- Phone : (267) 419-7710
Second Address
- Dr. Domenick Braccia
- 1035 Virginia Dr
- Fort Washington, PA
- Zip : 19034-3103
- Phone : (267) 419-7710
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Is Dr. Domenick Braccia a sole practitioner?
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 207Q00000X | Family Doctor | 0S006737L | PA |
| Y | 207QA0401X | Family Doctor - Addiction Medicine | 0S006737L | PA |
National Provider Identifier
| NPI | 1821178005 |
|---|---|
| Provider Name | Dr. Domenick Braccia |
| First Address | Fort Washington, PA 19034 |
| Second Address | Fort Washington, PA 19034-3103 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 16/10/2006 |
| Last Update Date | 17/03/2018 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 0012371310008 | (05) | PA |
| E70526 | (02) |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.