Provider Demographics
NPI:1942853957
Name:SHUSTER, BIANCA N (APRN)
Entity Type:Individual
Prefix:
First Name:BIANCA
Middle Name:N
Last Name:SHUSTER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:BIANCA
Other - Middle Name:
Other - Last Name:REGGIANO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:300 SEYMOUR AVE STE 202
Mailing Address - Street 2:
Mailing Address - City:DERBY
Mailing Address - State:CT
Mailing Address - Zip Code:06418-1343
Mailing Address - Country:US
Mailing Address - Phone:203-732-2651
Mailing Address - Fax:203-732-2654
Practice Address - Street 1:300 SEYMOUR AVE STE 202
Practice Address - Street 2:
Practice Address - City:DERBY
Practice Address - State:CT
Practice Address - Zip Code:06418-1343
Practice Address - Country:US
Practice Address - Phone:203-732-2651
Practice Address - Fax:203-732-2654
Is Sole Proprietor?:No
Enumeration Date:2019-07-18
Last Update Date:2022-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT8314363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner