Moeller-Bloom, Bernice
Moeller-Bloom, Bernice is an individual health care provider with primary practice located at 59 Myrtle Street Suite 100, Saratoga Springs NY 12866-1093. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Obstetrics & Gynecology, which is considered as her primary health care specialty. Moeller-Bloom, Bernice can be contacted via phone (518) 587-2400.Contact Information
Primary practice address
59 Myrtle Street Suite 100
Saratoga Springs NY 12866-1093
Phone: (518) 587-2400
Fax: (518) 581-0141
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Obstetrics & Gynecology | 363LX0001X | F3600631 | New York |
Profile Details
| NPI number | 1639173255 |
|---|---|
| LBN Legal business name | Moeller-Bloom, Bernice |
| Credentials | Nurse Practitioner (NP) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 10th, 2005 |
| Last updated | Mar 31st, 2016 - about 10 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 | 1639173255 | NPPES |
| New York | Other | 350498 | MVP |
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