Healthcare Provider Details

I. General information

NPI: 1336107887
Provider Name (Legal Business Name): DOMINIC M SCIAMANDA DO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/03/2006
Last Update Date: 07/24/2025
Certification Date: 07/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1920 W 8TH ST
ERIE PA
16505-4935
US

IV. Provider business mailing address

1920 W 8TH ST
ERIE PA
16505-4935
US

V. Phone/Fax

Practice location:
  • Phone: 814-456-1097
  • Fax: 814-287-9375
Mailing address:
  • Phone: 814-456-1097
  • Fax: 814-287-9375

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberOKO000013
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code204D00000X
TaxonomyNeuromusculoskeletal Medicine & OMM Physician
License NumberOS013178
License Number StatePA
# 3
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOS013178
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: