DOMENICK BRACCIA D.O. NPI 1952542615

NPI Information

  • NPI: 1952542615
  • Provider Name: DOMENICK BRACCIA D.O.
  • Classification: Clinic/Center - 261QM2500X
  • Specialization: Medical Specialty
  • Entity Type: Organization
  • Doing Business As: HAVERFORD WELLNESS CENTER
  • Address: 2010 W CHESTER PIKE
    SUITE 310
    HAVERTOWN, PA
    ZIP 19083
  • Phone: (610) 924-0600

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NPI Details

DOMENICK BRACCIA D.O. is a medical specialty clinic center in Havertown, PA. The provider is an entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer). DOMENICK BRACCIA D.O. NPI is 1952542615. The provider is registered as an organization entity type.
The provider Is Doing Business As Haverford Wellness Center.

The provider's business location address is:

2010 W CHESTER PIKE
SUITE 310
HAVERTOWN, PA
ZIP 19083-700
Phone: (610) 924-0600
Fax: (610) 924-0627

The provider's authorized official is Domenick Braccia .
The authorized official title is Medical Director and has the following contact phone number (610) 924-0600.

The enumeration date for this NPI number is 3/10/2009 and was last updated on 5/13/2009.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QH0100XClinic/CenterHealth ServiceOS006737LPENNSYLVANIANo
2261QI0500XClinic/CenterInfusion TherapyOS006737LPENNSYLVANIANo
3261QM1300XClinic/CenterMulti-SpecialtyOS006737LPENNSYLVANIANo
4261QP3300XClinic/CenterPainOS006737LPENNSYLVANIANo
5261QM2500XClinic/CenterMedical SpecialtyOS006737LPENNSYLVANIAYes

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 Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1648589MEDICARE PINPENNSYLVANIA
20012371310008MEDICAIDPENNSYLVANIA
3648523OTHERPENNSYLVANIABLUE SHIELD
41794675OTHERPENNSYLVANIABLUE SHIELD
5E70526MEDICARE UPINPENNSYLVANIA

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: 11/21/2025

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