Thomas M Domanick
Foot Surgery Primary Podiatric Medicine
1825 Barnum Ave
Stratford
, Connecticut 06614-5333
Thomas M Domanick
Foot Surgery Primary Podiatric Medicine
1825 Barnum Ave
Stratford
, Connecticut 06614-5333
(203) 377-1777
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About
Features
Specialties
- Primary Podiatric Medicine
- Foot Surgery
Languages spoken
- English
Location
First Address
- Thomas M Domanick
- 2660 Main St Suite 216
- Bridgeport, CT
- Zip : 06606-5369
- Phone : (203) 377-1777
Second Address
- Thomas M Domanick
- 1825 Barnum Ave
- Stratford, CT
- Zip : 06614-5333
- Phone : (203) 377-1777
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Is Thomas M Domanick accepting new patients?
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 213EP1101X | Primary Podiatric Medicine | P00289 | CT |
| N | 213ES0131X | Foot Surgery | P00289 | CT |
National Provider Identifier
| NPI | 1629012661 |
|---|---|
| Provider Name | Thomas M Domanick |
| First Address | Bridgeport, CT 06606-5369 |
| Second Address | Stratford, CT 06614-5333 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 16/06/2006 |
| Last Update Date | 07/01/2015 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 004051868 | (05) | CT |
| 004144309 | MEDICAID DME (01) | CT |
| 0071014 | AETNA (01) | CT |
| 030000289CT02 | ANTHEM BC/BS (01) | CT |
| 0V2746 | HEALTH NET (01) | CT |
| 0V2746 | HEALTH NET SMART CHOICE (01) | CT |
| T22076 | (02) | CT |
| ZS701 | OXFORD (01) | CT |
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.