Lori Dominiczak is a Pediatrics in Brown Deer, Wisconsin. Lori Dominiczak practices all healthcare services and medical treatments related to Pediatrics. The NPI Number for Lori Dominiczak is 1548450372. The last update date is 2007-07-27.
Lori Dominiczak's current location address is 4002 W Cherrywood Ln, Brown Deer, Wisconsin. You can contact this provider via phone number 4143783375. The mailing address for Lori Dominiczak is 4002 W Cherrywood Ln, Brown Deer, Wisconsin. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Lori Dominiczak |
|---|---|
| Address | 4002 W Cherrywood Ln, Brown Deer, Wisconsin |
| Phone Number | 4143783375 |
| Fax Number | |
| Sole Proprietor | Y |
| Credentials | PT |
NPI Number Detail
| NPI Number | 1548450372 |
|---|---|
| Provider Enumeration Date | 2007-07-27 |
| Last Updated Date | 2007-07-27 |
Provider Mailing Address Detail
| Address | 4002 W Cherrywood Ln |
|---|---|
| City | Brown Deer |
| State | Wisconsin (WI) |
| Post Code | 532091002 |
| Phone Number | 4143783375 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Pediatrics |
|---|---|
| Taxonomy | 2251P0200X |
| Licence No | 2714-024 |
|
Definition: A licensed physical therapist, including but not limited to an individual who is a Board Certified Specialist in Pediatric Physical Therapy, who has demonstrated specialized knowledge and skill in anatomy, histology, including embryonic development, |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 40440700 | WI | -- |
Post Comment/ Review Below
What is the unique identifier code issued to Lori Dominiczak by the Centers for Medicare & Medicaid Services (CMS)?
The Lori Dominiczak has been assigned the NPI (National Provider Identifier) 1548450372. This 10-digit code serves as a unique identification number for healthcare providers, issued by the CMS.
Could you provide the complete address where Lori Dominiczak is physically located?
The Lori Dominiczak is situated at the following address: 4002 W Cherrywood Ln, Brown Deer, WI 532091002.
What is Lori Dominiczak's primary field of medical specialization, and what is the corresponding taxonomy classification code for this area of expertise?
The primary field of medical specialization for Lori Dominiczak is Pediatrics, and the taxonomy classification code that categorizes this area of expertise is 2251P0200X.
On what date did the Centers for Medicare & Medicaid Services assign the 1548450372 to Lori Dominiczak?
The Centers for Medicare & Medicaid Services assigned the 1548450372 to Lori Dominiczak on 2007-07-27.
As of what date were the details pertaining to Lori Dominiczak last refreshed?
The information related to the Lori Dominiczak, including its address, specialty, and other relevant details, was last updated on 2007-07-27.
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