Raymond Anthony Domenico, PH.D., CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

000269-1 Issued in NY

Practice address

101 Broad St
224 Sibley Hall
Plattsburgh, NY 12901-2637

Phone

(518) 564-2170

Fax

(518) 564-5110

NPI assigned

Oct 12, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Plattsburgh State University Speech and Hearing Center

  • Hearing and Speech Clinic/Center
  • Plattsburgh, NY
  • NPI 1447221064
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1407945868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47 COGAN AVE",
            "city": "PLATTSBURGH",
            "state": "NY",
            "postal_code": "129012533",
            "telephone_number": "518-561-7882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 BROAD ST",
            "address_2": "224 SIBLEY HALL",
            "city": "PLATTSBURGH",
            "state": "NY",
            "postal_code": "129012637",
            "telephone_number": "518-564-2170",
            "fax_number": "518-564-5110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMENICO",
        "first_name": "RAYMOND",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "PH.D., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "000269-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Miriam Dick-Cohen, DDS
• George A Disney, M.D.
• Dana Dixon, RN
• Jeffrey Alan Dodge, DO
• Angela Marie Doe, CASAC
• Thomas Joseph Dominy, PHARM D
• Joseph Paul Donnery, DPM
• Kirsten Doran, DPT
• Nadine Downing, DPT
• Marc A Downs, RPA-C

• All providers in Plattsburgh, NY
• Speech-Language Pathologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.