Bloomstein, Jerry M
Bloomstein, Jerry M is an individual health care provider with primary practice located at 1220 Dewey Ave Bldg 2, Wauwatosa WI 53213-2504. He recently has only one registered license in Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry, which is considered as his primary health care specialty. Bloomstein, Jerry M can be contacted via phone (414) 454-6500.Contact Information
Primary practice address
1220 Dewey Ave Bldg 2
Wauwatosa WI 53213-2504
Phone: (414) 454-6500
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry | 2084P0804X | 28817 | Wisconsin |
Profile Details
| NPI number | 1356475594 |
|---|---|
| LBN Legal business name | Bloomstein, Jerry M |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 16th, 2007 |
| Last updated | Nov 23rd, 2021 - about 5 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 | 1356475594 | NPPES |
| Wisconsin | MEDICAID | 31465900 |
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