Bloom, Kenneth Edward
Bloom, Kenneth Edward is an individual health care provider with primary practice located at 1455 West Ave , Bronx NY 10462-7304. He recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatology, which is considered as his primary health care specialty. Bloom, Kenneth Edward can be contacted via phone (718) 239-1500.Contact Information
Primary practice address
1455 West Ave
Bronx NY 10462-7304
Phone: (718) 239-1500
Fax: (212) 765-3210
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Dermatology | 207N00000X | 169466 | New York |
Profile Details
| NPI number | 1477536068 |
|---|---|
| LBN Legal business name | Bloom, Kenneth Edward |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 28th, 2005 |
| Last updated | Aug 22nd, 2019 - 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 | 1477536068 | NPPES |
| New York | MEDICAID | 04134401 |
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