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General NPI Number Information
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NPI Number | 1902874670
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Entity Type | Individual
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Provider Name | ERIC J BLOOM MD
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Gender | Male
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Dates
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Enumeration Date | 03/09/2006
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Last Update Date | 09/11/2015
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Provider Practice Location Address
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Address Line | 5501 OLD YORK ROAD, MOSS 4TH FLOOR, SLEY BUILDING EINSTEIN NEPHROLOGY ASSOCIATES
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City | PHILADELPHIA
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State | PA
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Zip | 19141
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Country | US
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Telephone | 215-456-6970
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Fax | 215-456-7154
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Provider Business Mailing Address
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Address Line | 5501 OLD YORK ROAD, MOSS 4TH FLOOR, SLEY BUILDING EINSTEIN NEPHROLOGY ASSOCIATES
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City | PHILADELPHIA
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State | PA
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Zip | 19141
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Country | US
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Telephone | 215-456-6970
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Fax | 215-456-7154
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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 | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | MD035775E
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License Number State | PA
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