Organization
THOMAS M DOMANICK DPM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS M DOMANICK D,P.M. (OWNER)
(203) 377-1777
Entity
Organization
Contact information
Practice address
1825 BARNUM AVE, STRATFORD, CT 06614-5333
(203) 377-1777
(203) 378-8348
Mailing address
1825 BARNUM AVE, SUITE 302, STRATFORD, CT 06614-5333
(203) 377-1777
(203) 378-8348
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
POO289
CT
213ES0131X
Foot Surgery Podiatrist
Primary
POO289
CT
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Enumeration date
01/29/2008
Last updated
11/07/2012
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