Provider Demographics
NPI:1518278449
Name:THORPE, BIANCA FONTES (DO)
Entity Type:Individual
Prefix:DR
First Name:BIANCA
Middle Name:FONTES
Last Name:THORPE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:BIANCA
Other - Middle Name:FONTES
Other - Last Name:CAETANO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:289 PLEASANT ST
Mailing Address - Street 2:SUITE 502
Mailing Address - City:FALL RIVER
Mailing Address - State:MA
Mailing Address - Zip Code:02721-3005
Mailing Address - Country:US
Mailing Address - Phone:508-679-2505
Mailing Address - Fax:508-675-5554
Practice Address - Street 1:289 PLEASANT ST
Practice Address - Street 2:SUITE 502
Practice Address - City:FALL RIVER
Practice Address - State:MA
Practice Address - Zip Code:02721-3005
Practice Address - Country:US
Practice Address - Phone:508-679-2505
Practice Address - Fax:508-675-5554
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-25
Last Update Date:2013-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RILP02095207Q00000X
MA256900207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
RIRES-000Medicare UPIN