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General NPI Number Information
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NPI Number | 1922388107
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Entity Type | Individual
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Provider Name | GAIL M. BLOOM OTD, MA, OTR/L
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Gender | Female
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Dates
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Enumeration Date | 08/19/2011
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Last Update Date | 08/19/2011
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Provider Practice Location Address
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Address Line | 27 SOMERSET DR
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City | ANDOVER
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State | MA
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Zip | 01810-1249
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Country | US
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Telephone | 978-409-2233
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Fax |
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Provider Business Mailing Address
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Address Line | 27 SOMERSET DR
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City | ANDOVER
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State | MA
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Zip | 01810-1249
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Country | US
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Telephone | 978-409-2233
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Fax |
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | 863
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License Number State | MA
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