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Export Provider Record NPI 1205018470
David J Domenichini Md, Pc
Organization Subpart: NO
Active
NPI Number1205018470
NPI TypeNPI-2 Organization
SpecialtyInternal Medicine, Endocrinology, Diabetes & Metabolism
Provider Details
NPI1205018470
NPI TypeNPI-2 Organization
StatusActive
Enumeration Date2007-11-29
Last Updated2025-05-30
Authorized OfficialDavid Domenichini
Owner/Physician
Phone: 8605611007
Mailing Address701 Cottage Grove Rd Ste B220
Bloomfield, CT 06002-3077
United States
Phone: (860) 561-1007 | Fax: (860) 561-1222
📍 View Map
Primary Practice Address701 Cottage Grove Rd Ste B220
Bloomfield, CT 06002-3077
United States
Phone: (860) 561-1007 | Fax: (860) 561-1222
📍 View Map
Other Identifiers
IssuerStateNumberOther Issuer
Other (non-Medicare)CT500000218Medicaid Group
Other (non-Medicare)CT500000332Medicaid APRN Group
Other (non-Medicare)CT50DOMENICCT01Anthem Blue Cross/ Blue Shield Group
Other (non-Medicare)CTC03887Medicare Group
Other (non-Medicare)CTDH2482MEDICARE RAILROAD GROUP
Taxonomy / Specialty
PrimaryTaxonomy Code & DescriptionStateLicense Number
No207R00000X – Internal MedicineCT032306
No363L00000X – Nurse PractitionerCT032306
Yes207RE0101X – Internal Medicine, Endocrinology, Diabetes & MetabolismCT032306
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About NPI 1205018470

David J Domenichini Md, Pc is an organization registered in the CMS NPPES NPI Registry with NPI number 1205018470. The primary specialty listed is Internal Medicine, Endocrinology, Diabetes & Metabolism. The organization is located in Bloomfield, CT. This NPI is classified as a Type 2 (Organizational) NPI and is currently active. The NPI was first enumerated (assigned) on 2007-11-29. All data is sourced directly from the official CMS NPPES public API and is updated daily.

Frequently Asked Questions

What is NPI 1205018470?

NPI 1205018470 belongs to David J Domenichini Md, Pc, a Internal Medicine, Endocrinology, Diabetes & Metabolism in Bloomfield, CT. It is a Type 2 Organizational NPI registered in the CMS NPPES NPI Registry.

Is NPI 1205018470 active?

The current status of NPI 1205018470 in the NPPES registry is Active. The record was last updated on 2025-05-30.

What specialty is NPI 1205018470?

NPI 1205018470 is classified under the taxonomy Internal Medicine, Endocrinology, Diabetes & Metabolism. Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.

How do I verify NPI 1205018470?

You can verify NPI 1205018470 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.

What address is on file for NPI 1205018470?

The primary practice address on file for NPI 1205018470 is 701 Cottage Grove Rd Ste B220, Bloomfield, CT 06002-3077. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.

When was NPI 1205018470 issued?

NPI 1205018470 was first issued (enumerated) on 2007-11-29. The NPPES record was last updated on 2025-05-30.

Practice Location Map

David J Domenichini Md, Pc is located at 701 Cottage Grove Rd Ste B220, Bloomfield, CT. Use the map below to find directions or verify the practice location.

📍 701 Cottage Grove Rd Ste B220, Bloomfield, CT 06002-3077  ·  Open in Google Maps ↗

Related Healthcare Providers

The following providers share the same practice location, specialty, or state as David J Domenichini Md, Pc. All records sourced from the CMS NPPES registry.

License Information

The following state license numbers are on file in the NPPES registry for NPI 1205018470. For license status verification, contact the relevant state licensing board directly.

Specialty / TaxonomyLicense NumberState
Internal Medicine032306CT
Nurse Practitioner032306CT
Internal Medicine, Endocrinology, Diabetes & Metabolism032306CT
Data Verified from CMS NPPES Last synced: 2026-08-31 · Source: npiregistry.cms.hhs.gov · 45 CFR Part 162