Provider Demographics
NPI:1275582629
Name:BLOOMBERG, HARRIET (LCSW)
Entity Type:Individual
Prefix:
First Name:HARRIET
Middle Name:
Last Name:BLOOMBERG
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:329 ARGYLE RD
Mailing Address - Street 2:
Mailing Address - City:CEDARHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11516-1104
Mailing Address - Country:US
Mailing Address - Phone:516-295-1007
Mailing Address - Fax:
Practice Address - Street 1:329 ARGYLE RD
Practice Address - Street 2:
Practice Address - City:CEDARHURST
Practice Address - State:NY
Practice Address - Zip Code:11516-1104
Practice Address - Country:US
Practice Address - Phone:516-295-1007
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR027640-1104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYNU1791Medicare ID - Type Unspecified