Provider Demographics
NPI:1598837445
Name:BIANCARDI, MARCO (LIC ACUPUNCTURIST)
Entity Type:Individual
Prefix:DR
First Name:MARCO
Middle Name:
Last Name:BIANCARDI
Suffix:
Gender:M
Credentials:LIC ACUPUNCTURIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:180 DICKENSON ST
Mailing Address - Street 2:# 205
Mailing Address - City:LAHAINA
Mailing Address - State:HI
Mailing Address - Zip Code:96761
Mailing Address - Country:US
Mailing Address - Phone:808-661-9949
Mailing Address - Fax:808-667-6269
Practice Address - Street 1:180 DICKENSON ST
Practice Address - Street 2:SUITE # 205
Practice Address - City:LAHAINA
Practice Address - State:HI
Practice Address - Zip Code:96761-1215
Practice Address - Country:US
Practice Address - Phone:808-661-9949
Practice Address - Fax:808-667-6269
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI260171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist