MEDICARE: JOSEPH BIANCULLI L.AC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171100000X	Acupuncturist	004912-1	NY

General Provider Information

NPI Number	:	1669723458
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSEPH BIANCULLI L.AC.

Provider Business Mailing Address
First Line	:	226 50TH AVE APT 4H
Second Line	:
City	:	LONG ISLAND CITY
State	:	NY
Zip	:	11101-4512
Country	:	US
Telephone Number	:	631-831-0307
Fax Number	:

Provider Business Practice Location Address
First Line	:	226 50TH AVE APT 4H
Second Line	:
City	:	LONG ISLAND CITY
State	:	NY
Zip	:	11101-4512
Country	:	US
Telephone Number	:	631-831-0307
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/20/2012
Last Update Date	:	07/21/2022

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