Healthcare Provider Details

I. General information

NPI: 1982552386
Provider Name (Legal Business Name): BLOOM PSYCHIATRY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/20/2026
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

640 MARLBORO ST
KEENE NH
03431-4049
US

IV. Provider business mailing address

640 MARLBORO ST
KEENE NH
03431-4049
US

V. Phone/Fax

Practice location:
  • Phone: 603-435-2525
  • Fax:
Mailing address:
  • Phone: 603-852-0906
  • Fax: 980-500-1098

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: TONYA P CROSBY
Title or Position: MEDICAL DIRECTOR/ OWNER
Credential: PMHNP
Phone: 603-852-0906