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General NPI Number Information
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NPI Number | 1003263849
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Entity Type | Individual
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Provider Name | DOMINIC CERCONE
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Gender | Male
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Dates
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Enumeration Date | 05/23/2016
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Last Update Date | 09/18/2024
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Provider Practice Location Address
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Address Line | 11100 EUCLID AVE
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City | CLEVELAND
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State | OH
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Zip | 44106-1716
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Country | US
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Telephone | 216-844-1000
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Fax |
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Provider Business Mailing Address
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Address Line | 4401 PENN AVENUE ADMINISTRATIVE OFFICE BUILDING, SUITE 2400
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City | PITTSBURGH
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State | PA
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Zip | 15224-1334
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080P0204X
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Taxonomy Name | Pediatric Emergency Medicine (Pediatrics) Physician
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License Number | MD468996
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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