Provider Demographics
NPI:1871706333
Name:BIANCULLI, SILVIO P (L AC)
Entity type:Individual
Prefix:
First Name:SILVIO
Middle Name:P
Last Name:BIANCULLI
Suffix:
Gender:M
Credentials:L AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:307 SPRING ST APT 3R
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10013-1358
Mailing Address - Country:US
Mailing Address - Phone:917-445-9969
Mailing Address - Fax:
Practice Address - Street 1:189 MONTAGUE ST
Practice Address - Street 2:SUITE 920
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-3610
Practice Address - Country:US
Practice Address - Phone:718-802-0800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002218-1171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist