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Individual

DR. GREGORY S BLOOM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
112 QUARRY RD, SUITE 400, TRUMBULL, CT 06611-4816
(203) 333-8800
(203) 333-6054
Mailing address
112 QUARRY RD, SUITE 400, TRUMBULL, CT 06611-4816
(203) 333-8800
(203) 333-6054

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
045101
CT
207UN0901X
Nuclear Cardiology Physician
045101
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
045101
STATE LICENSE
CT
Enumeration date
02/12/2007
Last updated
03/07/2023
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