Antico, Dominic A
Antico, Dominic A is an individual health care provider with primary practice located at Hospital Road , Indiana PA 15701. He recently has 6 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Diagnostic Radiology, Allopathic & Osteopathic Physicians / Body Imaging, Allopathic & Osteopathic Physicians / Nuclear Radiology, Allopathic & Osteopathic Physicians / Pediatric Radiology, Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology, Allopathic & Osteopathic Physicians / Diagnostic Ultrasound. Allopathic & Osteopathic Physicians / Diagnostic Radiology is his primary health care specialty. Antico, Dominic A can be contacted via phone (724) 357-7125.Contact Information
Primary practice address
Hospital Road
Indiana PA 15701
Phone: (724) 357-7125
Fax: (724) 357-7487
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | MD013200E | Pennsylvania |
| Allopathic & Osteopathic Physicians / Body Imaging | 2085B0100X | MD013200E | Pennsylvania |
| Allopathic & Osteopathic Physicians / Nuclear Radiology | 2085N0904X | MD013200E | Pennsylvania |
| Allopathic & Osteopathic Physicians / Pediatric Radiology | 2085P0229X | MD013200E | Pennsylvania |
| Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology | 2085R0204X | MD013200E | Pennsylvania |
| Allopathic & Osteopathic Physicians / Diagnostic Ultrasound | 2085U0001X | MD013200E | Pennsylvania |
Profile Details
| NPI number | 1912958075 |
|---|---|
| LBN Legal business name | Antico, Dominic A |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 13th, 2006 |
| Last updated | Jul 8th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1912958075 | NPPES |
| Pennsylvania | MEDICAID | 0006874530007 | |
| Pennsylvania | Other | 155732 |
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