Healthcare Provider Details

I. General information

NPI: 1982271003
Provider Name (Legal Business Name): BIANCA DIAZ ARRINDELL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2021
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 N MAIN ST STE A
WATERBURY CT
06704-2364
US

IV. Provider business mailing address

PO BOX 745254
ATLANTA GA
30374-5254
US

V. Phone/Fax

Practice location:
  • Phone: 203-951-8306
  • Fax:
Mailing address:
  • Phone: 469-727-6675
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number79606
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: