Individual
DR. THOMAS BIANCANIELLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
57 SOUTHERN BLVD, SUITE 3, NESCONSET, NY 11767-1091
(631) 265-3300
(631) 265-3303
Mailing address
57 SOUTHERN BLVD, SUITE 3, NESCONSET, NY 11767-1091
(631) 265-3300
(631) 265-3303
Taxonomy
Speciality
Code
Description
License number
State
2080P0202X
Pediatric Cardiology Physician
Primary
127267
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00524474
—
NY
01
—
133908648
UNITEDHEALTHCARE EMPIRE PLAN NETWORK
NY
01
—
4313729
AETNA
NY
Enumeration date
06/14/2006
Last updated
10/05/2012
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