Provider Demographics
NPI:1235541152
Name:GERSHON, NAOMI BLOOM (MD)
Entity Type:Individual
Prefix:DR
First Name:NAOMI
Middle Name:BLOOM
Last Name:GERSHON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 HIGH ST STE 200
Mailing Address - Street 2:
Mailing Address - City:WESTWOOD
Mailing Address - State:MA
Mailing Address - Zip Code:02090-1100
Mailing Address - Country:US
Mailing Address - Phone:781-856-6530
Mailing Address - Fax:781-449-0580
Practice Address - Street 1:100 HIGH ST STE 200
Practice Address - Street 2:
Practice Address - City:WESTWOOD
Practice Address - State:MA
Practice Address - Zip Code:02090-1100
Practice Address - Country:US
Practice Address - Phone:781-856-6530
Practice Address - Fax:781-449-0580
Is Sole Proprietor?:No
Enumeration Date:2014-05-27
Last Update Date:2019-10-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA2706992080P0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0006XAllopathic & Osteopathic PhysiciansPediatricsDevelopmental - Behavioral Pediatrics