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Individual

MARK S BIANCHI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
55 LOCK STREET, NEW HAVEN, CT 06511
(203) 375-0050
(203) 380-1616
Mailing address
PO BOX 208237, NEW HAVEN, CT 06520-8237
(203) 375-0050
(203) 380-1616

Taxonomy

Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
035051
CT
207YX0007X
Plastic Surgery within the Head & Neck (Otolaryngology) Physician
035051
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
001350511
CT
Enumeration date
03/29/2006
Last updated
02/28/2012
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