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Individual

DR. TERESA IRENE BIANCO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
1100 GRAMPIAN BLVD, WILLIAMSPORT, PA 17701-1909
(570) 320-7525
(570) 320-7484
Mailing address
1201 GRAMPIAN BLVD, WILLIAMSPORT, PA 17701-1900

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
MD417420
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0018595800001
PA
01
1315333
HIGHMARK BLUE SHIELD
PA
01
153640
VALUE OPTIONS
PA
01
813859
FIRST PRIORITY HEALTH
PA
01
H32152
HEALTHAMERICA
PA
Enumeration date
03/29/2006
Last updated
02/10/2016
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