Provider Demographics
NPI:1255162871
Name:BIANCO, CATHERYN
Entity type:Individual
Prefix:
First Name:CATHERYN
Middle Name:
Last Name:BIANCO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 BOWDOIN RD
Mailing Address - Street 2:
Mailing Address - City:CENTEREACH
Mailing Address - State:NY
Mailing Address - Zip Code:11720-2301
Mailing Address - Country:US
Mailing Address - Phone:631-680-8594
Mailing Address - Fax:
Practice Address - Street 1:374 RILEY AVE
Practice Address - Street 2:
Practice Address - City:CALVERTON
Practice Address - State:NY
Practice Address - Zip Code:11933-1309
Practice Address - Country:US
Practice Address - Phone:631-315-7173
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-13
Last Update Date:2024-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist