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
Phone: (732) 235-7875
Fax: (732) 235-6620
Website:
Health care specialties
| Specialty | Code | License # | 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1578658720 | NPPES |
| New Jersey | MEDICAID | 0870706 |
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