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General NPI Number Information
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NPI Number | 1437657657
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Entity Type | Organization
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Legal Business Name | RALPH BIANCA, PH.D., L.C.S.W., L.C.A.D.C, LLC
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Dates
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Enumeration Date | 01/23/2018
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Last Update Date | 04/18/2022
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Provider Practice Location Address
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Address Line | 800 OLD SPRINGFIELD AVE APT 7
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City | SUMMIT
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State | NJ
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Zip | 07901-1129
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Country | US
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Telephone | 908-312-2019
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Fax |
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Provider Business Mailing Address
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Address Line | 800 OLD SPRINGFIELD AVE APT 7
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City | SUMMIT
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State | NJ
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Zip | 07901-1129
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Country | US
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Telephone | 908-312-2019
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | RALPH BIANCA
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Credential | PHD, LCSW, LCADC
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Telephone | 908-312-2019
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 44SC05738400
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License Number State | NJ
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