| 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 |
|---|---|
| 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 |
|---|---|
| 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 |
|---|---|
| Provider Enumeration Date | 11/29/2007 |
| Last Update Date | 10/31/2022 |
| Medicare PECOS PAC ID | 1759469612 |
|---|---|
| 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 |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1225004922 PECOS PAC ID: 0143257071 Enrollment ID: I20050722000365 |
| Provider Name | Joan F Corradino |
|---|---|
| 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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