Individual
DR. BLOSSOM JOY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
9963 BUSTLETON AVE, PHILADELPHIA, PA 19115-1557
(484) 885-7503
Mailing address
9963 BUSTLETON AVE, PHILADELPHIA, PA 19115-1557
(484) 885-7503
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
OS009215L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
268054800
—
FL
01
—
81600
BCBS
FL
Enumeration date
03/14/2006
Last updated
02/22/2021
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