Provider Demographics
NPI:1649355991
Name:BIANCO, RICHARD MICHAEL (DO)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:MICHAEL
Last Name:BIANCO
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 BULLOCKS POINT AVE APT 6B
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:RI
Mailing Address - Zip Code:02915-5373
Mailing Address - Country:US
Mailing Address - Phone:401-439-6787
Mailing Address - Fax:
Practice Address - Street 1:450 VETERANS MEMORIAL PKWY UNIT 15B
Practice Address - Street 2:
Practice Address - City:EAST PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02914-5300
Practice Address - Country:US
Practice Address - Phone:401-434-3350
Practice Address - Fax:401-434-5230
Is Sole Proprietor?:No
Enumeration Date:2006-10-26
Last Update Date:2018-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI00313207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
0005251176OtherAETNA
RI9003033Medicaid
4136OtherNHPRI
AA97197OtherHARVARD PILGRIM
1711103OtherCIGNA
RI3033OtherBCBS RIBS
404250OtherTUFTS
E09960Medicare UPIN
RI9003033Medicaid