MEDICARE: DR. NAOMI TERRY BLOOMFIELD M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician	153263	NY

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
5	160050364	OTHER	NY	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0005179467	OTHER	NY	AETNA
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	122774	OTHER	NY	WELLCARE
4	53G872	OTHER	NY	BLUE CROSS
6	16423	OTHER	NY	MVP
7	000405423002	OTHER	NY	BLUE SHIELD
8	040426006473	OTHER	NY	FIDELIS
9	10000175	OTHER	NY	CDPHP
10	29676	OTHER	NY	GHIHMO
11	00040492101	OTHER	NY	UNIVERA
12	0015055	OTHER	NY	GHI
13	141655014	OTHER	NY	EMPIRE PLAN
14	141655014	OTHER	NY	UNITED HEALTHCARE

General Provider Information

NPI Number	:	1588622930
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NAOMI TERRY BLOOMFIELD M.D.

Provider Business Mailing Address
First Line	:	711 TROY SCHENECTADY RD
Second Line	:	SUITE 203
City	:	LATHAM
State	:	NY
Zip	:	12110-2442
Country	:	US
Telephone Number	:	518-782-3700
Fax Number	:	518-782-3799

Provider Business Practice Location Address
First Line	:	101 JORDAN RD
Second Line	:	SUITE 200
City	:	TROY
State	:	NY
Zip	:	12180-8343
Country	:	US
Telephone Number	:	518-274-0476
Fax Number	:	518-274-0497

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/03/2006
Last Update Date	:	08/16/2013

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Directions to “ DR. NAOMI TERRY BLOOMFIELD M.D.” Practice Location

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