Individual
SANDRA L. BLOOM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
13 DRUIM MOIR LN, PHILADELPHIA, PA 19118-4134
(215) 248-5357
(215) 248-5367
Mailing address
13 DRUIM MOIR LN, PHILADELPHIA, PA 19118-4134
(215) 248-5357
(215) 248-5367
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
MD019329E
PA
Other
Enumeration date
09/21/2009
Last updated
09/21/2009
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