Individual
AMIE F BLOOM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
15 LINTON ST, SELKIRK, NY 12158-9740
(518) 312-0523
Mailing address
15 LINTON ST, SELKIRK, NY 12158-9740
(518) 312-0523
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
NY
Other
Enumeration date
08/29/2023
Last updated
08/29/2023
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