Individual
DR. GREGORY S BLOOM
Active
Individual
DR. GREGORY S BLOOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
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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