Bradley J Bloom
Pediatric Rheumatologist
1 Hoppin St Coro West
Providence
, Rhode Island 02903-4141
Bradley J Bloom
Pediatric Rheumatologist
1 Hoppin St Coro West
Providence
, Rhode Island 02903-4141
(401) 444-6378
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About
Features
Specialties
- Pediatric Rheumatologist
Languages spoken
- English
Location
First Address
- Bradley J Bloom
- 593 Eddy St Hasbro 122
- Providence, RI
- Zip : 02903-4923
- Fax : (401) 444-6378
- Phone : (401) 444-6484
Second Address
- Bradley J Bloom
- 1 Hoppin St Coro West
- Providence, RI
- Zip : 02903-4141
- Fax : (401) 793-8561
- Phone : (401) 793-8560
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 2080P0216X | Pediatric Rheumatologist | MD08885 | RI |
National Provider Identifier
| NPI | 1568643096 |
|---|---|
| Provider Name | Bradley J Bloom |
| First Address | Providence, RI 02903-4923 |
| Second Address | Providence, RI 02903-4141 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 27/11/2007 |
| Last Update Date | 29/02/2008 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| MD08885 | LICENSE (01) | RI |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.