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:
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Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
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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