Blom, Dennis
Blom, Dennis is an sole proprietor health care provider with primary practice located at 2202 Genesee St , Utica NY 13502. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Blom, Dennis can be contacted via phone (315) 732-0349.Contact Information
Primary practice address
2202 Genesee St
Utica NY 13502
Phone: (315) 732-0349
Fax: (315) 732-0309
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | 1060363A | Indiana |
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | 196361 | New York |
Profile Details
| NPI number | 1376501940 |
|---|---|
| LBN Legal business name | Blom, Dennis |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 3rd, 2006 |
| Last updated | Sep 11th, 2018 - about 7 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1376501940 | NPPES |
| New York | MEDICAID | 03107559 |
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