Individual
ANDREW JAMES BLOOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
142 ENGLE ST, ENGLEWOOD, NJ 07631-2547
(201) 568-0033
Mailing address
142 ENGLE ST, ENGLEWOOD, NJ 07631-2547
Taxonomy
Speciality
Code
Description
License number
State
213EP1101X
Primary Podiatric Medicine Podiatrist
Primary
25MD00373000
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0908096
—
NJ
Enumeration date
04/01/2020
Last updated
10/09/2024
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