Dematteo, Dominic

Dematteo, Dominic is an individual health care provider with primary practice located at 132 Abigail Ln , Port Matilda PA 16870-7153. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Dematteo, Dominic can be contacted via phone (814) 272-7100.

Contact Information

Primary practice address
132 Abigail Ln Port Matilda PA 16870-7153
Fax: (814) 272-6501
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X OS007877L Pennsylvania

Profile Details

NPI number 1457316804
LBN Legal business name Dematteo, Dominic
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 19th, 2006
Last updated Aug 31st, 2020 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1457316804 NPPES
Pennsylvania Other 053949 AOA
Pennsylvania MEDICAID 01564476 AOA

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