| Scott Bloom Md Pc | |
|
99 Jericho Tpke Suite 206 Jericho NY 11753-1073 | |
| (516) 338-2900 | |
| (516) 338-2901 |
| Full Name | Scott Bloom Md Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 99 Jericho Tpke, Jericho, New York |
| Authorized Official Name and Position | Scott Bloom (PRES) |
| Authorized Official Contact | 5163382900 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Scott Bloom Md Pc 380 N Broadway Ste 307 Jericho NY 11753-2109 Ph: (516) 835-4092 | Scott Bloom Md Pc 99 Jericho Tpke Suite 206 Jericho NY 11753-1073 Ph: (516) 338-2900 |
| NPI Number | 1295824530 |
|---|---|
| Provider Enumeration Date | 10/12/2006 |
| Last Update Date | 05/29/2023 |
| Medicare PECOS PAC ID | 4082615646 |
|---|---|
| Medicare Enrollment ID | O20070124000638 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295824530 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 162996 (New York) | Primary |
| Provider Name | Scott P Bloom |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1457432171 PECOS PAC ID: 7012924038 Enrollment ID: I20060316000374 |
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