Individual
DOMENICK BIANCHI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
APRN
Contact information
Practice address
201 CHESTNUT HILL RD, STAFFORD SPRINGS, CT 06076-4005
(413) 455-6638
Mailing address
103 STAFFORD ST, STAFFORD SPRINGS, CT 06076-4336
(413) 455-6638
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
8139
CT
Other
Enumeration date
04/05/2019
Last updated
04/05/2019
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