David J Domenichini Md, Pc | |
701 Cottage Grove Rd Ste B220 Bloomfield CT 06002-3077 | |
(860) 561-1007 | |
(860) 561-1222 |
Full Name | David J Domenichini Md, Pc |
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Speciality | Internal Medicine |
Location | 701 Cottage Grove Rd Ste B220, Bloomfield, Connecticut |
Authorized Official Name and Position | David J Domenichini (OWNER/PHYSICIAN) |
Authorized Official Contact | 8605611007 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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David J Domenichini Md, Pc 701 Cottage Grove Rd Ste B220 Bloomfield CT 06002-3077 Ph: (860) 561-1007 | David J Domenichini Md, Pc 701 Cottage Grove Rd Ste B220 Bloomfield CT 06002-3077 Ph: (860) 561-1007 |
NPI Number | 1205018470 |
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Provider Enumeration Date | 11/29/2007 |
Last Update Date | 07/31/2024 |
Medicare PECOS PAC ID | 1759469612 |
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Medicare Enrollment ID | O20080418000083 |
Identifier | Type | State | Issuer |
---|---|---|---|
1205018470 | NPI | - | NPPES |
C03887 | Other | CT | MEDICARE GROUP |
50DOMENICCT01 | Other | CT | ANTHEM BLUE CROSS/ BLUE SHIELD GROUP |
500000218 | Other | CT | MEDICAID GROUP |
500000332 | Other | CT | MEDICAID APRN GROUP |
DH2482 | Other | CT | MEDICARE RAILROAD GROUP |
Provider Name | David J Domenichini |
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Provider Type | Practitioner - Endocrinology |
Provider Identifiers | NPI Number: 1225004922 PECOS PAC ID: 0143257071 Enrollment ID: I20050722000365 |
Provider Name | Joan F Corradino |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1104849553 PECOS PAC ID: 6406852029 Enrollment ID: I20061004000540 |
Provider Name | Carolyn Elizabeth Considine |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1619400504 PECOS PAC ID: 3072933407 Enrollment ID: I20201023000102 |
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