Individual
DR. DOMENIC C IZZO JR.
Active
Individual
DR. DOMENIC C IZZO JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
MD029312E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0011323630001
—
PA
01
—
0019746000
KEYSTONE HEALTH EAST
PA
01
—
01854302
CAPITAL BLUE CROSS
PA
01
—
1800009426
RAILROAD MEDICARE
PA
01
—
4338999
AETNA
PA
01
—
473979
HIGHMARK BLUE SHIELD
PA
Enumeration date
10/26/2005
Last updated
07/08/2007
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