Provider Demographics
NPI:1821806563
Name:BIENIO, RICHARD CARL
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:CARL
Last Name:BIENIO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2142 MEADVILLE RD
Mailing Address - Street 2:
Mailing Address - City:TITUSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:16354-7046
Mailing Address - Country:US
Mailing Address - Phone:814-694-7069
Mailing Address - Fax:
Practice Address - Street 1:110 E CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:TITUSVILLE
Practice Address - State:PA
Practice Address - Zip Code:16354-1843
Practice Address - Country:US
Practice Address - Phone:814-827-4631
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-27
Last Update Date:2024-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP459129183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist