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Louis Domenico JR., MD
Vascular & Interventional Radiology Physician in Philadelphia, Pennsylvania
NPI 1942380902

Louis Domenico JR. is a Vascular & Interventional Radiology Physician based in Boston, PA and is specialized in Vascular & Interventional Radiology. Louis Domenico JR. practices in Philadelphia, PA and has the professional credentials of MD. The NPI Number for Louis Domenico JR. is 1942380902 and holds a License No. MD426532 (Pennsylvania).

The current practice location address for Louis Domenico JR. is 2412-14 West Passyunk Avenue, Philadelphia, PA and can be reached out via phone at 215-462-2100 and via fax at 215-462-3100.

Location: 2412-14 West Passyunk Avenue, Philadelphia, PA, 02241-6147
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1942380902
Provider Name
Louis Domenico JR.
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
2412-14 West Passyunk Avenue, Philadelphia, PA, 02241-6147
Phone Number
215-462-2100
Fax Number
215-462-3100
Provider Enumeration Date
10/16/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
0157562 05 NJ
P00823218 01 NJ RAILROAD MEDICARE
1017778250003 05 PA
institution
Provider Business Practice Location Address Details
Address
2412-14 West Passyunk Avenue
City
Philadelphia
State
Pennsylvania
Zip
19145-4114
Phone Number
215-462-2100
Fax Number
215-462-3100
person
Provider Business Mailing Address Details
Address
2412-14 West Passyunk Avenue
City
Philadelphia
State
Pennsylvania
Zip
19145-4114
Phone Number
215-462-2100
Fax Number
215-462-3100
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Radiology
Speciality
Diagnostic Radiology
Taxonomy
2085R0202X
License No.
25MA08328500 (New Jersey)
Definition
A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.
person
Provider's Taxonomy Details 2
Type
Allopathic & Osteopathic Physicians
Classification
Radiology
Speciality
Vascular & Interventional Radiology
Taxonomy
2085R0204X
License No.
MD426532 (Pennsylvania)
Definition
A radiologist who diagnoses and treats diseases by various radiologic imaging modalities. These include fluoroscopy, digital radiography, computed tomography, sonography and magnetic resonance imaging.
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