| Ralph Bianca, Ph.d., L.c.s.w., L.c.a.d.c, Llc | |
|
800 Old Springfield Ave Apt 7 Summit NJ 07901-1129 | |
| (908) 312-2019 | |
| Not Available |
| Full Name | Ralph Bianca, Ph.d., L.c.s.w., L.c.a.d.c, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 800 Old Springfield Ave Apt 7, Summit, New Jersey |
| Authorized Official Name and Position | Ralph Bianca (OWNER) |
| Authorized Official Contact | 9083122019 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ralph Bianca, Ph.d., L.c.s.w., L.c.a.d.c, Llc 800 Old Springfield Ave Apt 7 Summit NJ 07901-1129 Ph: (908) 312-2019 | Ralph Bianca, Ph.d., L.c.s.w., L.c.a.d.c, Llc 800 Old Springfield Ave Apt 7 Summit NJ 07901-1129 Ph: (908) 312-2019 |
| NPI Number | 1437657657 |
|---|---|
| Provider Enumeration Date | 01/23/2018 |
| Last Update Date | 04/18/2022 |
| Medicare PECOS PAC ID | 4981967668 |
|---|---|
| Medicare Enrollment ID | O20180410002957 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437657657 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 44SC05738400 (New Jersey) | Primary |
| Provider Name | Ralph Bianca |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1134630007 PECOS PAC ID: 5890058572 Enrollment ID: I20180410003019 |
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