Individual
DR. MICHELE L DOMIANO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OD
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
MD0417368
PA
152W00000X
Optometrist
Primary
OEG000869
PA
152W00000X
Optometrist
OEO07704T
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101849890
—
PA
01
—
1379469
BLUE CROSS/BLUE SHIELD
PA
01
—
814343
FIRST PRIORITY HEALTH
PA
Enumeration date
02/14/2006
Last updated
11/20/2008
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