Healthcare Provider Details

I. General information

NPI: 1881303782
Provider Name (Legal Business Name): DANIELLE MARIE BLOOMFIELD APN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/18/2022
Last Update Date: 11/18/2022
Certification Date: 09/21/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 MADISON AVE STE 405
MORRISTOWN NJ
07960-7305
US

IV. Provider business mailing address

101 MADISON AVE STE 405
MORRISTOWN NJ
07960-7305
US

V. Phone/Fax

Practice location:
  • Phone: 973-267-7272
  • Fax: 973-455-0099
Mailing address:
  • Phone: 973-267-7272
  • Fax: 973-455-0099

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number26NJ01397700
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: