Provider Demographics
NPI:1528247004
Name:BIANCA, ELAINE (OTR)
Entity type:Individual
Prefix:MRS
First Name:ELAINE
Middle Name:
Last Name:BIANCA
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2235 MILLERSPORT HWY
Mailing Address - Street 2:BEECHWOOD CONTINUING CARE
Mailing Address - City:GETZVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14068-1219
Mailing Address - Country:US
Mailing Address - Phone:716-504-1231
Mailing Address - Fax:716-504-2288
Practice Address - Street 1:2235 MILLERSPORT HWY
Practice Address - Street 2:BEECHWOOD CONTINUING CARE
Practice Address - City:GETZVILLE
Practice Address - State:NY
Practice Address - Zip Code:14068-1219
Practice Address - Country:US
Practice Address - Phone:716-504-1231
Practice Address - Fax:716-504-2288
Is Sole Proprietor?:No
Enumeration Date:2007-10-31
Last Update Date:2007-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009784-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist