Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Johnathan Mark Domenico, PA-C

Individual provider Physician Assistant · NPI 1346163367

Johnathan Mark Domenico, PA-C is a Physician Assistant in Potsdam, New York. Licensed in New York. Registered with an NPI since 2026.

Licensed in
NY
In the registry since
2026
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

See every abbreviation used in this directory →

Practice location Address checks out

8 Clarkson Ave
Potsdam, NY 13699-1401
Phone: (315) 268-2161
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X (NY)

Record details

NPI number1346163367
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedAugust 4, 2026
Last updated in NPPESAugust 4, 2026
Certification dateAugust 4, 2026

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