Provider Demographics
NPI:1952680795
Name:BLOOMGARDEN, NOAH AARON (MD)
Entity Type:Individual
Prefix:DR
First Name:NOAH
Middle Name:AARON
Last Name:BLOOMGARDEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1250 WATERS PL
Mailing Address - Street 2:TOWER TWO
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10461-2720
Mailing Address - Country:US
Mailing Address - Phone:866-633-8255
Mailing Address - Fax:
Practice Address - Street 1:1250 WATERS PL
Practice Address - Street 2:TOWER TWO
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461-2720
Practice Address - Country:US
Practice Address - Phone:866-633-8255
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-10
Last Update Date:2015-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY273017207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism