Provider Demographics
NPI:1841603289
Name:BIANCHI, TERESA (DO)
Entity Type:Individual
Prefix:
First Name:TERESA
Middle Name:
Last Name:BIANCHI
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2847 34TH ST APT 5
Mailing Address - Street 2:
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11103-5048
Mailing Address - Country:US
Mailing Address - Phone:917-374-5812
Mailing Address - Fax:
Practice Address - Street 1:2847 34TH ST APT 5
Practice Address - Street 2:
Practice Address - City:ASTORIA
Practice Address - State:NY
Practice Address - Zip Code:11103-5048
Practice Address - Country:US
Practice Address - Phone:917-374-5812
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-03
Last Update Date:2023-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2993532081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine