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Contact Information

MICHELE L DOMIANO, OD
189 N MAIN ST
OLD FORGE, PA18518
 Phone: 570-451-2020
 Fax: 570-451-3083
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Optometrist

152W00000X 41 Optometry
Indicates primary specialty

NPI Profile & details for MICHELE L DOMIANO · (Female)

NPI Number 1265406730
Status Active
Credentials OD (Doctor of Optometry)
Entity Individual
Enumeration date 02/14/2006
Last updated 11/20/2008 - About 18 years ago
Sole proprietor 1 Yes
Identifiers
  • PA License # MD0417368
  • PA License # OEG000869
  • PA License # OEO07704T
  • PA Medicaid 101849890
  • PA Other 1379469 BLUE CROSS/BLUE SHIELD
  • PA Other 814343 FIRST PRIORITY HEALTH
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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