Healthcare Provider Details

I. General information

NPI: 1871756783
Provider Name (Legal Business Name): AARON JAMES BIANCO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2008
Last Update Date: 04/05/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5719 WIDEWATERS PKWY
SYRACUSE NY
13214-1985
US

IV. Provider business mailing address

5824 WIDEWATERS PKWY
EAST SYRACUSE NY
13057-3072
US

V. Phone/Fax

Practice location:
  • Phone: 315-251-3100
  • Fax: 315-449-9923
Mailing address:
  • Phone: 315-251-3105
  • Fax: 315-552-6018

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number264069
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207XS0117X
TaxonomyOrthopaedic Surgery of the Spine Physician
License Number264069
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: