Bloom, Bradley J

Bloom, Bradley J is an individual health care provider with primary practice located at 1 Hoppin St Coro West, Providence RI 02903-4141. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatric Rheumatology, which is considered as his primary health care specialty. Bloom, Bradley J can be contacted via phone (401) 793-8560.

Contact Information

Primary practice address
1 Hoppin St Coro West Providence RI 02903-4141
Phone: (401) 793-8560
Fax: (401) 793-8561
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatric Rheumatology 2080P0216X MD08885 Rhode Island

Profile Details

NPI number 1568643096
LBN Legal business name Bloom, Bradley J
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 27th, 2007
Last updated Feb 29th, 2008 - about 17 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1568643096 NPPES
Rhode Island Other MD08885 LICENSE

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