Provider Demographics
NPI:1326226531
Name:JOSEPH C BIONDOLILLO
Entity type:Organization
Organization Name:JOSEPH C BIONDOLILLO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:M
Authorized Official - Last Name:SKRZYNSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:716-649-1010
Mailing Address - Street 1:206 LAKE ST
Mailing Address - Street 2:
Mailing Address - City:HAMBURG
Mailing Address - State:NY
Mailing Address - Zip Code:14075-4471
Mailing Address - Country:US
Mailing Address - Phone:716-649-1010
Mailing Address - Fax:
Practice Address - Street 1:206 LAKE ST
Practice Address - Street 2:
Practice Address - City:HAMBURG
Practice Address - State:NY
Practice Address - Zip Code:14075-4471
Practice Address - Country:US
Practice Address - Phone:716-649-1010
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-11
Last Update Date:2008-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV0038391332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0771550001Medicare NSC