Individual
MR. AKIVAH M BLOOM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.S. ED
Contact information
Practice address
2516 AVENUE W, BROOKLYN, NY 11229-4927
(917) 685-2164
Mailing address
2516 AVENUE W, BROOKLYN, NY 11229-4927
(917) 685-2164
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
174400000X - SPECIAL
—
NY
Enumeration date
06/12/2012
Last updated
07/21/2022
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