Provider Demographics
NPI:1265911804
Name:BLOOM, VICTORIA B (CD (DTI))
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:B
Last Name:BLOOM
Suffix:
Gender:F
Credentials:CD (DTI)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 HOLLYWOOD DR
Mailing Address - Street 2:
Mailing Address - City:DOBBS FERRY
Mailing Address - State:NY
Mailing Address - Zip Code:10522-3027
Mailing Address - Country:US
Mailing Address - Phone:914-450-9574
Mailing Address - Fax:
Practice Address - Street 1:8 HOLLYWOOD DR
Practice Address - Street 2:
Practice Address - City:DOBBS FERRY
Practice Address - State:NY
Practice Address - Zip Code:10522-3027
Practice Address - Country:US
Practice Address - Phone:914-450-9574
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-13
Last Update Date:2018-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula