Individual
ERIC J. BLOOM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
38 NORTH ST, MONTICELLO, NY 12701-1711
(845) 794-4930
(845) 794-4842
Mailing address
PO BOX 1020, MONTICELLO, NY 12701-1020
(845) 794-4930
(845) 794-4842
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
NY2879
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00520241
—
NY
Enumeration date
11/01/2006
Last updated
10/16/2008
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