Individual
GLEN M BIANCHI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
300 FAIRVIEW AVENUE, WESTWOOD, NJ 07675
(201) 666-4014
(201) 666-4754
Mailing address
PO BOX 698, 300 FAIRVIEW AVENUE, WESTWOOD, NJ 07675
(201) 666-4014
(201) 666-4754
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
25MA 07744000
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
222103828
BCBS
—
01
—
P00228763
RR MEDICARE
—
Enumeration date
05/16/2006
Last updated
11/13/2007
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