person
Thomas M Domanick, DP,M,
Foot Surgery Podiatrist in Stratford, Connecticut
NPI 1629012661

Thomas M Domanick is a Foot Surgery Podiatrist based in Bridgeport, CT and is specialized in Foot Surgery. Thomas M Domanick practices in Stratford, CT and has the professional credentials of DP,M,. The NPI Number for Thomas M Domanick is 1629012661 and holds a License No. P00289 (Connecticut).

The current practice location address for Thomas M Domanick is 1825 Barnum Ave, Stratford, CT and can be reached out via phone at 203-377-1777.

Location: 1825 Barnum Ave, Stratford, CT, 06606-5369
person
Provider Profile Details
NPI Number
1629012661
Provider Name
Thomas M Domanick
Credential
DP,M,
Provider Entity Type
Individual
Gender
Male
Address
1825 Barnum Ave, Stratford, CT, 06606-5369
Phone Number
203-377-1777
Fax Number
Provider Enumeration Date
06/16/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
004051868 05 CT
0V2746 01 CT HEALTH NET
ZS701 01 CT OXFORD
004144309 01 CT MEDICAID DME
0V2746 01 CT HEALTH NET SMART CHOICE
0071014 01 CT AETNA
030000289CT02 01 CT ANTHEM BC/BS
institution
Provider Business Practice Location Address Details
Address
1825 Barnum Ave
City
State
Zip
06614-5333
Phone Number
203-377-1777
Fax Number
person
Provider Business Mailing Address Details
Address
1825 Barnum Ave
City
State
Zip
06614-5333
Phone Number
203-377-1777
Fax Number
person
Provider's Taxonomy Details 1
Type
Podiatric Medicine & Surgery Service Providers
Classification
Podiatrist
Speciality
Primary Podiatric Medicine
Taxonomy
License No.
P00289 (Connecticut)
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Podiatric Medicine & Surgery Service Providers
Classification
Podiatrist
Speciality
Foot Surgery
Taxonomy
License No.
P00289 (Connecticut)
Definition
Definition to come...
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