Izzo, Domenic C

Izzo, Domenic C is an individual health care provider with primary practice located at 1802 Papermill Rd , Wyomissing PA 19610-1100. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Izzo, Domenic C can be contacted via phone (610) 372-0712.

Contact Information

Primary practice address
1802 Papermill Rd Wyomissing PA 19610-1100
Fax: (610) 376-6968
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X MD029312E Pennsylvania

Profile Details

NPI number 1225028624
LBN Legal business name Izzo, Domenic C
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 26th, 2005
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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1225028624 NPPES
Pennsylvania MEDICAID 0011323630001
Pennsylvania Other 1800009426
Pennsylvania Other 4338999
Pennsylvania Other 01854302
Pennsylvania Other 473979
Pennsylvania Other 0019746000

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