DOMENICK BRACCIA D.O.; NPI #1952542615

Contact Information

DOMENICK BRACCIA D.O.

2010 W CHESTER PIKE
SUITE 310
HAVERTOWN, PA 19083-2700

Phone: 610-924-0600
Fax: 610-924-0627
Website:

Specialty	Taxonomy Code	Specialty Code	Provider Type
Medical Specialty	261QM2500X
Health Service	261QH0100X
Infusion Therapy	261QI0500X
Multi-Specialty	261QM1300X	70	Clinic or Group Practice
Pain	261QP3300X

Indicates primary specialty

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NPI Profile & details for DOMENICK BRACCIA D.O.

NPI # 1952542615

LBN Legal business name DOMENICK BRACCIA D.O.

Authorized official DOMENICK BRACCIA - (MEDICAL DIRECTOR)

Entity Organization

Organization subpart ¹ No

Enumeration date 03/10/2009

Last updated 05/13/2009 - About 17 years ago

Identifiers

PA	License #	OS006737L
PA	Medicaid	0012371310008
PA	Other	1794675	BLUE SHIELD
PA	Other	648523	BLUE SHIELD

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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DOMENICK BRACCIA D.O.

Contact Information

Specialty

Medical Specialty

Health Service

Infusion Therapy

Multi-Specialty

Pain

NPI Profile & details for DOMENICK BRACCIA D.O.

Reviews for DOMENICK BRACCIA D.O.