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General NPI Number Information
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NPI Number | 1649355991
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Entity Type | Individual
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Provider Name | RICHARD MICHAEL BIANCO DO
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Gender | Male
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Dates
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Enumeration Date | 10/26/2006
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Last Update Date | 11/30/2018
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Provider Practice Location Address
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Address Line | 450 VETERANS MEMORIAL PKWY UNIT 15B
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City | EAST PROVIDENCE
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State | RI
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Zip | 02914-5300
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Country | US
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Telephone | 401-434-3350
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Fax | 401-434-5230
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Provider Business Mailing Address
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Address Line | 31 BULLOCKS POINT AVE APT 6B
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City | RIVERSIDE
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State | RI
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Zip | 02915-5373
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Country | US
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Telephone | 401-439-6787
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 00313
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License Number State | RI
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