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Domenick Braccia D.o.
Pain Clinic/Center in Havertown, Pennsylvania
NPI 1952542615

Domenick Braccia D.o. is a Pain Clinic/Center based in Havertown, PA and is specialized in Pain. Domenick Braccia D.o. practices in Havertown, PA. The NPI Number for Domenick Braccia D.o. is 1952542615 and holds a License No. OS006737L (Pennsylvania).

The current practice location address for Domenick Braccia D.o. is 2010 W Chester Pike, Havertown, PA and can be reached out via phone at 610-924-0600 and via fax at 610-924-0627.

Location: 2010 W Chester Pike, Havertown, PA, 19083-2700
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1952542615
Provider Name
Domenick Braccia D.o.
Credential
Provider Entity Type
Organization
Address
2010 W Chester Pike, Havertown, PA, 19083-2700
Phone Number
610-924-0600
Fax Number
610-924-0627
Provider Enumeration Date
03/10/2009
Last Update Date
03/12/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
0012371310008 05 PA
1794675 01 PA BLUE SHIELD
648523 01 PA BLUE SHIELD
institution
Provider Business Practice Location Address Details
Address
2010 W Chester Pike
City
Havertown
State
Pennsylvania
Zip
19083-2700
Phone Number
610-924-0600
Fax Number
610-924-0627
person
Provider Business Mailing Address Details
Address
2010 W Chester Pike
City
Havertown
State
Pennsylvania
Zip
19083-2700
Phone Number
610-924-0600
Fax Number
610-924-0627
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Health Service
Taxonomy
261QH0100X
License No.
OS006737L (Pennsylvania)
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Infusion Therapy
Taxonomy
261QI0500X
License No.
OS006737L (Pennsylvania)
Definition
Definition to come...
person
Provider's Taxonomy Details 3
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Multi-Specialty
Taxonomy
261QM1300X
License No.
OS006737L (Pennsylvania)
Definition
Definition to come...
person
Provider's Taxonomy Details 4
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Medical Specialty
Taxonomy
261QM2500X
License No.
OS006737L (Pennsylvania)
Definition
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer).
person
Provider's Taxonomy Details 5
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Pain
Taxonomy
261QP3300X
License No.
OS006737L (Pennsylvania)
Definition
Definition to come...
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