Individual
DR. ANTHONY DOMENICO
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
56 SCHOOLHOUSE RD, WHITING, NJ 08759-3052
(732) 716-1300
(732) 716-1290
Mailing address
13B BIRCHWOOD DR, WHITING, NJ 08759-1732
(732) 350-3763
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
25MD00084900
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1720503
—
NJ
Enumeration date
08/01/2005
Last updated
07/08/2007
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