Provider Demographics
NPI:1326926494
Name:BIANCULLI, EMMA
Entity type:Individual
Prefix:
First Name:EMMA
Middle Name:
Last Name:BIANCULLI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 HADLEY RD
Mailing Address - Street 2:
Mailing Address - City:MERRIMAC
Mailing Address - State:MA
Mailing Address - Zip Code:01860-1306
Mailing Address - Country:US
Mailing Address - Phone:978-994-2578
Mailing Address - Fax:
Practice Address - Street 1:60 HADLEY RD
Practice Address - Street 2:
Practice Address - City:MERRIMAC
Practice Address - State:MA
Practice Address - Zip Code:01860-1306
Practice Address - Country:US
Practice Address - Phone:978-994-2578
Practice Address - Fax:978-994-2578
Is Sole Proprietor?:No
Enumeration Date:2025-08-26
Last Update Date:2025-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAAPRN10005005363LF0000X
MARN2361527163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse