Provider Demographics
NPI:1689678492
Name:BIANCHINI, JOSEPH J (DPM)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:J
Last Name:BIANCHINI
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 259
Mailing Address - Street 2:
Mailing Address - City:SOUTHBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06488-0259
Mailing Address - Country:US
Mailing Address - Phone:203-791-0466
Mailing Address - Fax:203-791-2001
Practice Address - Street 1:57 NORTH ST
Practice Address - Street 2:SUITE 108
Practice Address - City:DANBURY
Practice Address - State:CT
Practice Address - Zip Code:06810-5660
Practice Address - Country:US
Practice Address - Phone:203-791-0466
Practice Address - Fax:860-791-2001
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-09
Last Update Date:2014-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000580213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT030000580CT04OtherBLUECROSS AND SHEILD
0041532001OtherBLUECARE FAMILY PLAN
5058395OtherAETNA HEALTH PLANS
LIS096OtherOXFORD HEALTH PLANS
CT580007OtherCONNECTICARE INC
OR3520OtherHEALTHNET
CT004151320Medicaid
480019713OtherRAILROAD MEDICARE
5218254OtherCIGNA HEALTH PLANS
CT030000580CT04OtherBLUECROSS AND SHEILD
U42794Medicare UPIN