Healthcare Provider Details

I. General information

NPI: 1700882610
Provider Name (Legal Business Name): NORMA BILBOOL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2005
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

222 ROUTE 59 SUITE 106
SUFFERN NY
10901-5204
US

IV. Provider business mailing address

26 FIREMENS MEMORIAL DR 115
POMONA NY
10970-3553
US

V. Phone/Fax

Practice location:
  • Phone: 800-750-8616
  • Fax: 845-362-8474
Mailing address:
  • Phone: 800-750-8616
  • Fax: 845-362-8474

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number045759
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number10712
License Number StateMT

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier10712
Identifier TypeOTHER
Identifier StateMT
Identifier IssuerMONTANA STATE LICENSE
# 2
Identifier000084498
Identifier TypeOTHER
Identifier StateMT
Identifier IssuerUNKNOWN
# 3
Identifier250000407
Identifier TypeOTHER
Identifier StateCT
Identifier IssuerMEDICARE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: