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Andrew James Bloom
Primary Podiatric Medicine Podiatrist in Newark, New Jersey
NPI 1750919957

Andrew James Bloom is a Primary Podiatric Medicine Podiatrist based in Greenlawn, NJ and is specialized in Primary Podiatric Medicine. Andrew James Bloom practices in Newark, NJ. The NPI Number for Andrew James Bloom is 1750919957 and holds a License No. 25MD00373000 (New Jersey).

The current practice location address for Andrew James Bloom is 150 Bergen St # G-142, Newark, NJ and can be reached out via phone at 973-972-5088.

Location: 150 Bergen St # G-142, Newark, NJ, 11740-1024
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1750919957
Provider Name
Andrew James Bloom
Credential
Provider Entity Type
Individual
Gender
Male
Address
150 Bergen St # G-142, Newark, NJ, 11740-1024
Phone Number
973-972-5088
Fax Number
Provider Enumeration Date
04/01/2020
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
0908096 05 NJ
institution
Provider Business Practice Location Address Details
Address
150 Bergen St # G-142
City
Newark
State
New Jersey
Zip
07103-2496
Phone Number
973-972-5088
Fax Number
person
Provider Business Mailing Address Details
Address
150 Bergen St # G-142
City
Newark
State
New Jersey
Zip
07103-2496
Phone Number
973-972-5088
Fax Number
person
Provider's Taxonomy Details 1
Type
Podiatric Medicine & Surgery Service Providers
Classification
Podiatrist
Speciality
Primary Podiatric Medicine
Taxonomy
213EP1101X
License No.
25MD00373000 (New Jersey)
Definition
Definition to come...
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