Individual
DR. DOMINICK ANTHONY SICONOLFI III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
18 E LAUREL RD, STRATFORD, NJ 08084-1327
(856) 346-7985
Mailing address
18 E LAUREL RD, STRATFORD, NJ 08084-1327
(856) 346-7985
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
25MB11059000
NJ
207P00000X
Emergency Medicine Physician
72901
MN
Other
Enumeration date
06/04/2018
Last updated
10/02/2024
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