Individual
DOMENIC WILLIAM CASABLANCA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
42 E HIGH ST STE 205, EAST HAMPTON, CT 06424-1073
(860) 358-3500
Mailing address
28 CRESCENT ST, MIDDLETOWN, CT 06457-3650
(860) 358-6000
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
037602
CT
207Q00000X
Family Medicine Physician
204552
NY
207Q00000X
Family Medicine Physician
MA060820
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001376020
—
CT
Enumeration date
04/27/2006
Last updated
02/04/2026
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