Dicicco-Bloom, Emanuel M.

Dicicco-Bloom, Emanuel M. is an sole proprietor health care provider with primary practice located at 89 French St Ste 2300 , New Brunswick NJ 08901-1935. He recently has only one registered license in Allopathic & Osteopathic Physicians / Neurodevelopmental Disabilities, which is considered as his primary health care specialty. Dicicco-Bloom, Emanuel M. can be contacted via phone (732) 235-7875.

Contact Information

Primary practice address
89 French St Ste 2300 New Brunswick NJ 08901-1935
Fax: (732) 235-6620
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Neurodevelopmental Disabilities 2080P0008X MA54781 New Jersey
Allopathic & Osteopathic Physicians / Neurodevelopmental Disabilities 2080P0008X 25MA05478100 New Jersey

Profile Details

NPI number 1578658720
LBN Legal business name Dicicco-Bloom, Emanuel M.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 4th, 2006
Last updated Jul 23rd, 2021 - about 3 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 1578658720 NPPES
New Jersey MEDICAID 0870706

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