Individual provider · Type 1 NPI

Sean D. Domzalski, PA-C

Medical Physician Assistant · Wilkes-Barre, PA

NPI number 1003213919 Active

Practice location

150 Mundy Street, Mac IV Building
Wilkes-Barre, PA 18702

Call (570) 824-0930 Map

Fax (570) 824-7755

Mailing address

243 S Prospect St
Nanticoke, PA 18634-2449

Specialties and licenses

TaxonomyCodeLicense
Medical Physician Assistant Primary 363AM0700XMA057321 (PA)

Medical Physician Assistant: Definition to come...

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About NPI 1003213919

Sean D. Domzalski, PA-C's National Provider Identifier is 1003213919, issued on Nov 21, 2014. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Wilkes-Barre, PA. The record was last updated on Sep 21, 2015.