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| Type | Person | [sources] | |||
|---|---|---|---|---|---|
| Name | Domenick Braccia | [sources] | |||
| Birth date | [sources] | ||||
| Nationality | not available | [sources] | |||
| Country | United States | [sources] | |||
| First name | Domenick | [sources] | |||
| ID Number | Lic# OS006737L · OS006737L · PROMIS# 001237131 | [sources] | |||
| Last name | Braccia | [sources] | |||
| NPI | 1821178005 | [sources] | |||
| Sector | 207Q00000X, 207R00000X, 132700000X, 2080A0000X, 213E00000X,20 80A0000X | [sources] | |||
| Title | DO | [sources] | |||
| Position | FAMILY PRACTICE (PHYSICIAN (MD, DO)) | [sources] | |||
| Address | (NJ), (NJ) · JOINT BASE MDL, NJ 08640, USA · P O BOX 2000, #77212-066, JOINT BASE MDL, NJ 08640 | [sources] | |||
| Last change | Last processed | First seen | |||
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us-medpa-f7c42b6c3afeac9ef19c8207c3487a1b73db41c3 · us-fed-excl-domenick-braccia-08640-joint-base-mdl · us-medde-96c7adfd94389eca845726a4f805187a97f54dbaFor experts: raw data explorer
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| Address | ||
|---|---|---|
| Full address | Country | |
| (NJ), (NJ) · NJ, NJ | United States | |
| United States | OPM | Reciprocal | - |
| United States | OIG/Pennsylvania Department of Human services | - | - |
| United States | Department of Health and Human Services Office of Inspector General | List of Excluded Individuals/Entities (LEIE) | - |
| United States | Department of Human Services | - | - |