# DAVID J DOMENICHINI MD, PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1205018470
- **Authorized official:** DR. DAVID J DOMENICHINI M.D. (OWNER/PHYSICIAN)
- **Authorized official phone:** (860) 561-1007

## Contact information

- **Practice address:** 701 COTTAGE GROVE RD STE B220, BLOOMFIELD, CT 06002-3077
- **Practice address phone:** (860) 561-1007
- **Practice address fax:** (860) 561-1222
- **Mailing address:** 701 COTTAGE GROVE RD STE B220, BLOOMFIELD, CT 06002-3077
- **Mailing address phone:** (860) 561-1007
- **Mailing address fax:** (860) 561-1222

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | 032306 | CT | — |
| 207RE0101X | Endocrinology, Diabetes & Metabolism Physician | 032306 | CT | Yes |
| 363L00000X | Nurse Practitioner | 032306 | CT | — |

## Other

- **Enumeration date:** 11/29/2007
- **Last updated:** 05/30/2025