Provider Demographics
NPI:1477213858
Name:BLOOM OT
Entity type:Organization
Organization Name:BLOOM OT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:ZAMBIGTO
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:631-353-5210
Mailing Address - Street 1:37 GREENPOINT AVE
Mailing Address - Street 2:SUITE 308/MAILBOX 31
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11222
Mailing Address - Country:US
Mailing Address - Phone:631-353-5210
Mailing Address - Fax:
Practice Address - Street 1:37 GREENPOINT AVE STE 308
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11222-1545
Practice Address - Country:US
Practice Address - Phone:631-353-5210
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-27
Last Update Date:2021-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Multi-Specialty