Healthcare Provider Details

I. General information

NPI: 1205896610
Provider Name (Legal Business Name): MARIE ANN BIANCHI N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2006
Last Update Date: 10/13/2022
Certification Date: 10/13/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 RED CREEK DR STE 200
ROCHESTER NY
14623
US

IV. Provider business mailing address

600 RED CREEK DR STE 200
ROCHESTER NY
14623-4300
US

V. Phone/Fax

Practice location:
  • Phone: 585-244-5670
  • Fax: 585-338-1477
Mailing address:
  • Phone: 585-244-5670
  • Fax: 585-338-1477

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberF302582
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberF302582-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: