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General NPI Number Information
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NPI Number | 1790812121
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Entity Type | Organization
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Legal Business Name | MICHAEL A. BIANCO, M.D., P.C.
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Dates
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Enumeration Date | 02/27/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3 BOYLE RD
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City | SELDEN
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State | NY
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Zip | 11784-4030
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Country | US
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Telephone | 631-736-3372
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Fax | 631-736-1332
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Provider Business Mailing Address
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Address Line | 3 BOYLE RD
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City | SELDEN
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State | NY
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Zip | 11784-4030
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Country | US
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Telephone | 631-736-3372
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Fax | 631-736-1332
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Authorized Official
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Title or Position | MEDICAL DOCTOR
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Name | DR. MICHAEL A BIANCO
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Credential | MD
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Telephone | 631-736-3372
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 204408-1
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License Number State | NY
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