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General NPI Number Information
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NPI Number | 1861047193
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Entity Type | Organization
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Legal Business Name | BFPS PC
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Dates
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Enumeration Date | 08/04/2019
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Last Update Date | 12/09/2021
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Provider Practice Location Address
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Address Line | 2 TOWN PL STE 110
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City | BRYN MAWR
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State | PA
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Zip | 19010-3420
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Country | US
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Telephone | 215-900-2806
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Fax |
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Provider Business Mailing Address
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Address Line | 2 TOWN PL STE 110
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City | BRYN MAWR
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State | PA
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Zip | 19010-3420
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Country | US
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Telephone | 610-762-5666
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. JASON DAVID BLOOM
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Credential | MD
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Telephone | 215-900-2806
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207YS0123X
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Taxonomy Name | Facial Plastic Surgery Physician
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License Number |
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License Number State |
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