Individual
ANITA R BLOOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, FAAA
Contact information
Practice address
3900 WOODLAND AVE, PHILADELPHIA, PA 19104
(215) 823-6395
(215) 823-4585
Mailing address
405 SHAWMONT AVE APT E, PHILA, PA 19128-4037
(215) 483-4965
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
AT000429L
PA
Other
Enumeration date
08/18/2006
Last updated
07/08/2007
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