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General NPI Number Information
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NPI Number | 1356255509
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Entity Type | Organization
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Legal Business Name | ELDERBLOOM WELLNESS LLC
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Dates
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Enumeration Date | 10/02/2026
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Last Update Date | 10/02/2026
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Provider Practice Location Address
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Address Line | 57 MAYER DR
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City | SUFFERN
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State | NY
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Zip | 10901-3728
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Country | US
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Telephone | 954-366-2700
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Fax |
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Provider Business Mailing Address
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Address Line | 57 MAYER DR
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City | SUFFERN
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State | NY
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Zip | 10901-3728
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | CHAIM UHR
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Credential |
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Telephone | 954-366-2700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State | NULL
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