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DOMONIQUE NATHAN MD, MS
NPI 1114812955
Student in an Organized Health Care Education/Training Program in Philadelphia, PA

Active since June 11, 2025
10800 KNIGHTS RD, PHILADELPHIA, PA 19114(215) 612-5161 Get Directions Write a Review

NPPES record last updated: June 11, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Domonique Nathan Md, Ms NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DOMONIQUE NATHAN MD, MS (NPI 1114812955) is an individual student in an organized health care education/training program in Philadelphia, Pennsylvania, licensed in Pennsylvania (MT235348) and active in the NPI registry since June 2025.

NPPES Registry Identity

NPI1114812955
Entity TypeIndividualFemale
Primary Taxonomy390200000X
Provider Legal NameDOMONIQUE NATHANCredential: MD, MS
Location Address10800 KNIGHTS RDPhiladelphia, PA 19114-4200
Mailing Address10800 Knights RdPhiladelphia, PA 19114-4200
Phone(215) 612-5161
Sole ProprietorNo
Enumeration DateJune 11, 2025
NPPES CertifiedJune 11, 2025
✔ NPI 1114812955 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
License✔ Licensed in PA · MT235348
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
10800 KNIGHTS RD, Philadelphia, PA 19114
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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MANSI SHETH DO
Student in an Organized Health Care Education/Training Program
10800 KNIGHTS RD
PHILADELPHIA, PA 19114
Philadelphia County (215) 612-5161
CHERYL LYNNE GEE-MAURER CRNP
Nurse Practitioner (Primary Care)
10800 KNIGHTS RD
PHILADELPHIA, PA 19114
Philadelphia County (215) 612-4000
HEATHER MOORE RN
Nurse Anesthetist, Certified Registered
10800 KNIGHTS RD
PHILADELPHIA, PA 19114
Philadelphia County (215) 612-4000
IAN LUMSDEN PA-C
Surgery (Trauma Surgery)
10800 KNIGHTS RD
PHILADELPHIA, PA 19114
Philadelphia County (215) 612-4064
PETER J GRELLA
Student in an Organized Health Care Education/Training Program
10800 KNIGHTS RD
PHILADELPHIA, PA 19114
Philadelphia County (215) 612-5161
DR. KRISHNA KOTHAMASU DO
Student in an Organized Health Care Education/Training Program
10800 KNIGHTS RD
PHILADELPHIA, PA 19114
Philadelphia County (215) 612-4000
GRETCHEN DAWN OVERTON DPM
Student in an Organized Health Care Education/Training Program
10800 KNIGHTS RD
PHILADELPHIA, PA 19114
Philadelphia County (215) 612-5161
MS. BONNIE VITTI-HUOT PA-C
Physician Assistant
10800 KNIGHTS RD
PHILADELPHIA, PA 19114
Philadelphia County (215) 612-4000

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Domonique Nathan's NPI number?

The NPI number for Domonique Nathan is 1114812955. It was assigned to this individual provider in the NPPES registry on June 11, 2025.

Where is Domonique Nathan located?

Domonique Nathan practices at 10800 Knights Rd, Philadelphia, PA 19114. The listed phone number is (215) 612-5161.

What is Domonique Nathan's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

When was this NPI record last updated?

The NPPES record for Domonique Nathan was last updated on June 11, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.