Individual
DR. MARC BLOOMENSTEIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
884
AZ
152WC0802X
Corneal and Contact Management Optometrist
884
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
86-0884211
TAX ID
—
Enumeration date
04/25/2006
Last updated
04/26/2022
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