Individual
MS. ENID DENISE BLOOM
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
MS RD CDN
Contact information
Practice address
179TH STREET AND LINDEN BLVD, ST. ALBANS, NY 11425
(718) 526-1000
Mailing address
198 WELLINGTON RD S, GARDEN CITY, NY 11530-5519
(516) 564-0186
Taxonomy
Speciality
Code
Description
License number
State
133NN1002X
Nutrition Education Nutritionist
Primary
001217
NY
Other
Enumeration date
06/12/2006
Last updated
07/08/2007
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