Individual
MARIA BLOOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
31 BIRCH ST, PORT WASHINGTON, NY 11050-4339
(516) 816-2773
Mailing address
31 BIRCH ST, PORT WASHINGTON, NY 11050-4339
(516) 816-2773
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
009150-1
NY
Other
Enumeration date
09/07/2017
Last updated
07/21/2022
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