Provider Demographics
NPI:1285189050
Name:DOMINICK, NICHOLAS (DO, PHARMD)
Entity Type:Individual
Prefix:
First Name:NICHOLAS
Middle Name:
Last Name:DOMINICK
Suffix:
Gender:M
Credentials:DO, PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3600 FORBES AVE STE 140
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15213-3410
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:815 FREEPORT RD
Practice Address - Street 2:UPMC ST. MARGARET, DEPT MEDICAL EDUCATION
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15215
Practice Address - Country:US
Practice Address - Phone:412-784-4227
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-22
Last Update Date:2022-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program