Individual
BRADLEY STEPHEN BLOOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1125 PARK AVE, NEW YORK, NY 10128-1243
(212) 876-3319
(212) 423-0840
Mailing address
1125 PARK AVE, NEW YORK, NY 10128-1243
(212) 876-3319
(212) 423-0840
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
25MA09583800
NJ
207N00000X
Dermatology Physician
Primary
262147
NY
Other
Enumeration date
05/04/2010
Last updated
10/13/2022
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