Individual
DR. TANYA SARAH BLOOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
322 N AURORA ST, ITHACA, NY 14850-4202
(607) 277-4749
Mailing address
322 N AURORA ST, ITHACA, NY 14850-4202
(607) 277-4749
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
008632
NY
152W00000X
Optometrist
3039
CT
152WV0400X
Vision Therapy Optometrist
3039
CT
152WV0400X
Vision Therapy Optometrist
Primary
8632
NY
Other
Enumeration date
06/14/2017
Last updated
05/02/2019
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