Healthcare Provider Details

I. General information

NPI: 1861382236
Provider Name (Legal Business Name): DOMINA SPINE INSTITUTE, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/08/2025
Last Update Date: 07/08/2025
Certification Date: 07/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

470 JOHNSON RD STE 210
WASHINGTON PA
15301-8944
US

IV. Provider business mailing address

470 JOHNSON RD STE 210
WASHINGTON PA
15301-8944
US

V. Phone/Fax

Practice location:
  • Phone: 412-997-0494
  • Fax:
Mailing address:
  • Phone: 412-997-0494
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207XS0117X
TaxonomyOrthopaedic Surgery of the Spine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License Number
License Number State

VIII. Authorized Official

Name: THOMAS MONKO
Title or Position: PRACTICE MANAGER
Credential:
Phone: 412-997-0494