Healthcare Provider Details

I. General information

NPI: 1689678492
Provider Name (Legal Business Name): JOSEPH J BIANCHINI D.P.M.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/09/2005
Last Update Date: 04/14/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

57 NORTH ST SUITE 108
DANBURY CT
06810-5660
US

IV. Provider business mailing address

PO BOX 259
SOUTHBURY CT
06488-0259
US

V. Phone/Fax

Practice location:
  • Phone: 203-791-0466
  • Fax: 860-791-2001
Mailing address:
  • Phone: 203-791-0466
  • Fax: 203-791-2001

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number000580
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: