Provider Demographics
NPI:1194724294
Name:JAPAL, H BIANCA (MD)
Entity type:Individual
Prefix:DR
First Name:H BIANCA
Middle Name:
Last Name:JAPAL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 704
Mailing Address - Street 2:
Mailing Address - City:UNIONDALE
Mailing Address - State:NY
Mailing Address - Zip Code:11553-0704
Mailing Address - Country:US
Mailing Address - Phone:516-481-2080
Mailing Address - Fax:516-481-2095
Practice Address - Street 1:1151 FRONT ST
Practice Address - Street 2:STE 115
Practice Address - City:UNIONDALE
Practice Address - State:NY
Practice Address - Zip Code:11553-2035
Practice Address - Country:US
Practice Address - Phone:516-481-2080
Practice Address - Fax:516-481-2095
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-20
Last Update Date:2016-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY201651207R00000X
FLME92089207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01705619Medicaid
NY01705619Medicaid
NY775731Medicare ID - Type Unspecified