1689678492 NPI number — DR. JOSEPH J BIANCHINI D.P.M.

Table of content: DR. JOSEPH J BIANCHINI D.P.M. (NPI 1689678492)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1689678492 NPI number — DR. JOSEPH J BIANCHINI D.P.M.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BIANCHINI
Provider First Name:
JOSEPH
Provider Middle Name:
J
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
D.P.M.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1689678492
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/14/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 259
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SOUTHBURY
Provider Business Mailing Address State Name:
CT
Provider Business Mailing Address Postal Code:
06488-0259
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
203-791-0466
Provider Business Mailing Address Fax Number:
203-791-2001

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
57 NORTH ST
Provider Second Line Business Practice Location Address:
SUITE 108
Provider Business Practice Location Address City Name:
DANBURY
Provider Business Practice Location Address State Name:
CT
Provider Business Practice Location Address Postal Code:
06810-5660
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
203-791-0466
Provider Business Practice Location Address Fax Number:
860-791-2001
Provider Enumeration Date:
06/09/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 213E00000X , with the licence number:  000580 , registered in the state of CT ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 030000580CT04 . This is a "BLUECROSS AND SHEILD" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 0041532001 . This is a "BLUECARE FAMILY PLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 5058395 . This is a "AETNA HEALTH PLANS" identifier . This identifiers is of the category "OTHER".
  • Identifier: LIS096 . This is a "OXFORD HEALTH PLANS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 580007 . This is a "CONNECTICARE INC" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: OR3520 . This is a "HEALTHNET" identifier . This identifiers is of the category "OTHER".
  • Identifier: 004151320 , issued by the state of ( CT ) . This identifiers is of the category "MEDICAID".
  • Identifier: 480019713 . This is a "RAILROAD MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 5218254 . This is a "CIGNA HEALTH PLANS" identifier . This identifiers is of the category "OTHER".




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