Provider Demographics
NPI:1023540747
Name:BIANCHINI-MACCIOCCHI LLC
Entity Type:Organization
Organization Name:BIANCHINI-MACCIOCCHI LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:
Authorized Official - Last Name:MACCIOCCHI
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:504-780-1702
Mailing Address - Street 1:2901 N I 10 SERVICE RD E
Mailing Address - Street 2:STE 300
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70002-6137
Mailing Address - Country:US
Mailing Address - Phone:504-780-1702
Mailing Address - Fax:
Practice Address - Street 1:5775 PEACHTREE DUNWOODY RD NE
Practice Address - Street 2:BUILDING C SUITE 200
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342-1501
Practice Address - Country:US
Practice Address - Phone:404-623-5206
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-31
Last Update Date:2017-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty