Individual provider · Type 1 NPI

Justin Domingo, MD

Student in an Organized Health Care Education/Training Program · Wynnewood, PA

NPI number 1689316499 Active

Practice location

100 E Lancaster Ave
Wynnewood, PA 19096-3450

Call (484) 476-1619 Map

Mailing address

1257 Judy Rd
Mohegan Lake, NY 10547-1904

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1689316499

Justin Domingo, MD's National Provider Identifier is 1689316499, issued on Apr 12, 2022. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Wynnewood, PA. The record was last updated on Apr 12, 2022.