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Individual

DR. MICHELLE EMILY BLOOM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
212 JERICHO TPKE, MINEOLA, NY 11501-1613
(516) 663-4480
(516) 663-6947
Mailing address
14 WALL ST FL 9, NEW YORK, NY 10005-2178

Taxonomy

Speciality
Code
Description
License number
State
207RA0001X
Advanced Heart Failure and Transplant Cardiology Physician
Primary
232791
NY
207RC0000X
Cardiovascular Disease Physician
232791
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
232791
MEDICAL LICENSE NUMBER 232791
NY
Enumeration date
05/28/2008
Last updated
05/11/2026
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