Provider Demographics
NPI:1609673821
Name:BIANCAMANO, MICHAEL ALOYSIUS (DPT)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:ALOYSIUS
Last Name:BIANCAMANO
Suffix:
Gender:
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:311 CALVIN ST
Mailing Address - Street 2:
Mailing Address - City:TOWNSHIP OF WASHINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07676-5020
Mailing Address - Country:US
Mailing Address - Phone:201-621-2043
Mailing Address - Fax:
Practice Address - Street 1:49 W ALLENDALE AVE
Practice Address - Street 2:
Practice Address - City:ALLENDALE
Practice Address - State:NJ
Practice Address - Zip Code:07401-1754
Practice Address - Country:US
Practice Address - Phone:201-825-0623
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-26
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA02318000225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist