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General NPI Number Information
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NPI Number | 1093194631
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Entity Type | Individual
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Provider Name | SYDNEY DOMANOWSKI DO
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Gender | Female
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Dates
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Enumeration Date | 05/28/2015
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Last Update Date | 06/09/2020
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Provider Practice Location Address
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Address Line | 408 N MAIN ST
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City | WARSAW
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State | NY
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Zip | 14569-1015
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Country | US
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Telephone | 585-786-1560
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Fax |
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Provider Business Mailing Address
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Address Line | 263 LIBERTY ST STE 2
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City | ARCADE
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State | NY
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Zip | 14009-1626
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Country | US
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Telephone | 585-496-5007
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 299071-1
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License Number State | NY
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