Individual
DR. RAPHAEL T BLOOMGARDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1722 BETHLEHEM PIKE, CHESTNUT HILL CARDIOLOGY LTD, FLOURTOWN, PA 19031-1644
(215) 233-9700
(215) 233-9710
Mailing address
3500 N BROAD ST RM 1A, PHILADELPHIA, PA 19140-4106
(215) 926-9019
(215) 233-9710
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
MD027044E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1007278000
MEDICAID TPI GROUP
PA
01
—
597586
MEDICARE TPI GROUP
PA
01
—
CD4829
RAILROAD MEDICARE TPI
PA
Enumeration date
05/05/2006
Last updated
07/03/2024
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