Individual
DOMINICK A. COMMODARO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
2807 BRISTOL PIKE, BENSALEM, PA 19020-5362
(215) 639-1281
(215) 639-3016
Mailing address
PO BOX 8500-6335, PHILADELPHIA, PA 19178-0001
(215) 807-8000
(215) 807-8235
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
OS005617L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0010424620001
—
PA
05
—
0010424620003
—
PA
05
—
0010424620004
—
PA
05
—
0010424620005
—
PA
01
—
121502
HIGHMARK BLUE SHIELD
PA
01
—
30041893
KEYSTONE MERCY
PA
01
—
37957
HEALTH PARTNERS
PA
01
—
4076113
AETNA PPO
PA
01
—
93539
AETNA HMO
PA
Enumeration date
11/14/2006
Last updated
02/10/2014
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