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1740403641 NPI number — DIANE MANUS-BIANCULLI NP,C

NPI Number: 1740403641
Health Care Provider/Practitioner: DIANE MANUS-BIANCULLI NP,C

Information about “1740403641” NPI (DIANE MANUS-BIANCULLI NP,C) exists in 1740403641 in HTML format HTML  |  1740403641 in plain Text format TXT  |  1740403641 in PDF (Portable Document Format) PDF  |  1740403641 in an XML format XML  formats.

NPI Number : 1740403641 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1740403641",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "MANUS-BIANCULLI",
    "FirstName": "DIANE",
    "MiddleName": null,
    "NamePrefix": "MS.",
    "NameSuffix": null,
    "Credential": "NP,C",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "BIANCULLI",
    "OtherFirstName": "DIANE",
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": "NP,C",
    "OtherLastNameTypeCode": "5",
    "FirstLineMailingAddress": "1600 BRECKNOCK RD",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "GREENPORT",
    "MailingAddressStateName": "NY",
    "MailingAddressPostalCode": "11944-3100",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "631-477-4216",
    "MailingAddressFaxNumber": "631-477-4065",
    "FirstLinePracticeLocationAddress": "1600 BRECKNOCK RD",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "GREENPORT",
    "PracticeLocationAddressStateName": "NY",
    "PracticeLocationAddressPostalCode": "11944-3100",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "631-477-4216",
    "PracticeLocationAddressFaxNumber": "631-477-4065",
    "EnumerationDate": "04/10/2007",
    "LastUpdateDate": "07/09/2007",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "363LA2200X",
        "TaxonomyName": "Adult Health Nurse Practitioner",
        "LicenseNumber": "F302342",
        "LicenseNumberStateCode": "NY",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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