Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 035051 | CT |
N | 207YX0007X | Plastic Surgeon (Head & Neck) | 035051 | CT |
NPI | 1073574166 |
---|---|
Provider Name | Mark S Bianchi |
First Address | New Haven, CT 06520-8237 |
Second Address | New Haven, CT 06511 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/03/2006 |
Last Update Date | 28/02/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
001350511 | (05) | CT |
G24818 | (02) |