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SEAN D DOMZALSKI PA-C NPI 1003213919


NPI Information

NPI: 1003213919
Provider Name: SEAN D DOMZALSKI, PA-C
Classification: Physician Assistant - 363AM0700X
Entity Type: Individual

Specialization: Medical

Address:
150 MUNDY STREET
MAC IV BUILDING
WILKES-BARRE, PA
ZIP 18702
Phone: (570) 824-0930
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Sean D Domzalski, PA-C is a medical physician assistant in Wilkes-barre, PA. Sean D Domzalski, PA-C NPI is 1003213919. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

150 MUNDY STREET
MAC IV BUILDING
WILKES-BARRE, PA
ZIP 18702
Phone: (570) 824-0930
Fax: (570) 824-7755

The enumeration date for this NPI number is 11/21/2014 and was last updated on 9/21/2015.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1363AM0700XPhysician AssistantMedicalMA057321PENNSYLVANIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
150130489OTHERPENNSYLVANIACAPITAL BLUE CROSS
2388537J67MEDICARE PINPENNSYLVANIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/15/2022

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.