Braccia, Domenick

Braccia, Domenick is an individual health care provider with primary practice located at 1035 Virginia Dr , Fort Washington PA 19034-3103. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Addiction Medicine. Allopathic & Osteopathic Physicians / Addiction Medicine is his primary health care specialty. Braccia, Domenick can be contacted via phone (267) 419-7710.

Contact Information

Primary practice address
1035 Virginia Dr Fort Washington PA 19034-3103
Phone: (267) 419-7710
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 0S006737L Pennsylvania
Allopathic & Osteopathic Physicians / Addiction Medicine 207QA0401X 0S006737L Pennsylvania

Profile Details

NPI number 1821178005
LBN Legal business name Braccia, Domenick
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 16th, 2006
Last updated Mar 17th, 2018 - about 7 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1821178005 NPPES
Pennsylvania MEDICAID 0012371310008

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