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MRS. EDNA MARISELA BIANCANIELLO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
AGACNP

Contact information

Practice address
39 BRENTWOOD RD, BAY SHORE, NY 11706-8031
(631) 591-7400
Mailing address
PO BOX 5329, BAY SHORE, NY 11706-0233
(631) 805-4680

Taxonomy

Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
F432087
NY

Other

Enumeration date
09/25/2021
Last updated
09/25/2021
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