Individual
DR. JONATHAN BLOOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
400 WHITE SPRUCE BLVD STE B, ROCHESTER, NY 14623
(585) 275-2838
(585) 424-1338
Mailing address
601 ELMWOOD AVE BOX 656, ROCHESTER, NY 14642-3481
(585) 275-2838
(585) 424-1338
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
298018
NY
208800000X
Urology Physician
Primary
D0083134
MD
Other
Enumeration date
09/15/2014
Last updated
06/30/2023
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