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General NPI Number Information
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NPI Number | 1669638409
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Entity Type | Individual
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Provider Name | RACHEL BLOOM M.D.
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Gender | Female
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Dates
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Enumeration Date | 07/31/2008
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Last Update Date | 07/31/2008
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Provider Practice Location Address
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Address Line | 100 W 26TH ST APT. 22A
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City | NEW YORK
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State | NY
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Zip | 10001-6840
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Country | US
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Telephone | 516-702-8920
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Fax | 212-454-1186
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Provider Business Mailing Address
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Address Line | 100 W 26TH ST APT. 22A
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City | NEW YORK
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State | NY
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Zip | 10001-6840
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Country | US
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Telephone | 516-702-8920
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Fax | 212-454-1186
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 249825
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License Number State | NY
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