Healthcare Provider Details

I. General information

NPI: 1962333112
Provider Name (Legal Business Name): BLOOMING HEALTH INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/27/2026
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13 CRANBERRY HOLW
ENFIELD CT
06082-2242
US

IV. Provider business mailing address

13 CRANBERRY HOLW
ENFIELD CT
06082-2242
US

V. Phone/Fax

Practice location:
  • Phone: 413-222-2918
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State

VIII. Authorized Official

Name: SALLIE CZEPIEL
Title or Position: AUTHORIZED OFFICIAL/ CEO
Credential: RD
Phone: 413-222-2918