National Provider Identifier
Angelina M Domena
Angelina M Domena is listed in the NPPES registry with a primary specialty of Athletic Trainer in Ithaca, NY and a listed phone number of (607) 274-3011.
Profile Overview
- NPI
- 1790319499
- Provider Type
- Individual
- Primary Specialty
- Athletic Trainer
- Enumeration Date
- March 03, 2020
- Last Updated
- March 03, 2020
Practice Location
- 953 Danby RD
- Ithaca, NY 14850-7002
Phone: (607) 274-3011
Mailing Address
- 138 Lincoln Ave
- Waddington, NY 13694-3100
Specialties
- Athletic Trainer (2255A2300X)
Full Record
- NPI
- 1790319499
- Entity Type
- Individual
- Last Name
- Domena
- First Name
- Angelina
- Middle Name
- M
- Mailing Street Address
- 138 Lincoln Ave
- Mailing City
- Waddington
- Mailing State
- NY
- Mailing ZIP Code
- 13694-3100
- Mailing Country
- US
- Mailing Phone
- (315) 388-4299
- Practice Street Address
- 953 Danby RD
- Practice City
- Ithaca
- Practice State
- NY
- Practice ZIP Code
- 14850-7002
- Practice Country
- US
- Practice Phone
- (607) 274-3011
- Enumeration Date
- March 03, 2020
- Last Updated
- March 03, 2020
- Sex
- Female
- Sole Proprietor
- Yes
- Certification Date
- March 03, 2020
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Athletic Trainer (2255A2300X)