Basic Information
Provider Information
NPI: 1740950419
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: TOSCANO
FirstName: BIANCA
MiddleName: CLAIRE
NamePrefix: MS.
NameSuffix:  
Credential: PA-C
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 131 E AMES CT
Address2:  
City: PLAINVIEW
State: NY
PostalCode: 118032317
CountryCode: US
TelephoneNumber: 5164247919
FaxNumber:  
Practice Location
Address1: 3333 NEW HYDE PARK RD
Address2:  
City: NEW HYDE PARK
State: NY
PostalCode: 110421204
CountryCode: US
TelephoneNumber: 5164395300
FaxNumber:  
Other Information
ProviderEnumerationDate: 09/15/2021
LastUpdateDate: 09/15/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 09/15/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363AM0700X027234NYY Physician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical

No ID Information.


Home