Bloomingdale, Kerry L
Bloomingdale, Kerry L is an individual health care provider with primary practice located at 1132 Westfield St , West Springfield MA 01089-3878. He recently has only one registered license in Allopathic & Osteopathic Physicians / Psychiatry, which is considered as his primary health care specialty. Bloomingdale, Kerry L can be contacted via phone (800) 378-5454.Contact Information
Primary practice address
1132 Westfield St
West Springfield MA 01089-3878
Phone: (800) 378-5454
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Psychiatry | 2084P0800X | 43793 | Massachusetts |
Profile Details
| NPI number | 1326039181 |
|---|---|
| LBN Legal business name | Bloomingdale, Kerry L |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 2nd, 2005 |
| Last updated | May 16th, 2011 - about 15 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 | 1326039181 | NPPES |
| Massachusetts | Other | 15-00675 | EVERCARE |
| Massachusetts | Other | 719405 | EVERCARE |
| Massachusetts | Other | C04856 | EVERCARE |
| Massachusetts | Other | C04856 | EVERCARE |
| Massachusetts | Other | 719405 | EVERCARE |
| Massachusetts | MEDICAID | O167959 | EVERCARE |
| Massachusetts | Other | C04856 | EVERCARE |
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