Individual
FERNANDO B DOMONDON JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
S 3669 SOUTHWESTERN BLVD, MERCY AMBULATORY CARE CENTER, ORCHARD PARK, NY 14127
(716) 204-4500
(716) 204-4501
Mailing address
6653 MAIN ST, WILLIAMSVILLE, NY 14221-5906
(716) 204-4500
(716) 204-4501
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
196197
NY
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
196197-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01610939
—
NY
Enumeration date
05/16/2006
Last updated
06/28/2023
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