Provider Demographics
NPI:1336564640
Name:BLOOM, VALERIE (MPAS, PA-C)
Entity Type:Individual
Prefix:
First Name:VALERIE
Middle Name:
Last Name:BLOOM
Suffix:
Gender:F
Credentials:MPAS, PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2350 NOBLESTOWN RD
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15205-4128
Mailing Address - Country:US
Mailing Address - Phone:412-458-5042
Mailing Address - Fax:
Practice Address - Street 1:2350 NOBLESTOWN RD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15205-4128
Practice Address - Country:US
Practice Address - Phone:412-458-5042
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-24
Last Update Date:2021-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA056554363A00000X
WV741363A00000X
PAOA004117363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant