Ivy Bloom, MSED Valid NPI
Individual provider · Specialist · Oceanside, NY
- NPI
- 1942562400
- Type
- Individual (Type 1)
- Primary specialty
- Specialist
- Specialty group
- Other Service Providers
- Taxonomy code
- 174400000X
- Sex
- Female
- Sole proprietor
- Yes
- Enumerated
- 2012-06-11
- Last updated
- 2012-06-11
Practice location
122 Jeffery Ln
Oceanside, NY 11572-5936
(516) 678-3728