Laura Michele Didomenico, M.D.
Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology in Philadelphia, PA. Individual provider (NPI-1).
NPI number1861925158
StatusActive
Last updated in NPPESSep 5, 2023
Details
- NPI
- 1861925158
- Entity type
- Individual (NPI-1)
- Name
- Laura Michele Didomenico
- Credential
- M.D.
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Apr 4, 2017
- Certification date
- Sep 5, 2023
- Last updated
- Sep 5, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2084N0402X | Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology | MD480381 | PA | Yes |
Practice location
3401 Civic Center BlvdSuite M975
Philadelphia, PA 19104-3364
Phone 215-514-3451
Mailing address
3333 Burnet AveMlc 2015
Cincinnati, OH 45229-3026
Phone 513-636-4222 · Fax 513-636-1888
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