Organization
BLOOMING PEDIATRIC & FAMILY NURSE PRACTITIONERS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CORAL MONTANA NP (OWNER)
(315) 662-0162
Entity
Organization
Contact information
Practice address
1 OXFORD XING STE 3, NEW HARTFORD, NY 13413-3200
(315) 662-0162
Mailing address
1 OXFORD XING STE 3, NEW HARTFORD, NY 13413-3200
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Enumeration date
01/19/2022
Last updated
01/19/2022
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