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1003041377
STANLEY BLOOM
OLD FORGE, NY
NPI
1003041377
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
208800000X Urology
(Licence: NY 099606-1)
Enumeration Date
2009-05-15
Last Update Date
2009-05-15
Business Address
-- STANLEY BLOOM md
138 GOODELL RD
OLD FORGE, NY 13420
Phone number: 315-369-2003
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Mailing Address
-- STANLEY BLOOM md
10760 NORTH GREEN DR
LAKE WORTH, FL 33449
Phone number: 561-432-2020
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