Provider Demographics
NPI:1700569639
Name:BLOOM, STEVEN G (RRT)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:G
Last Name:BLOOM
Suffix:
Gender:M
Credentials:RRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 TOQUET ST
Mailing Address - Street 2:
Mailing Address - City:HASKELL
Mailing Address - State:NJ
Mailing Address - Zip Code:07420-1319
Mailing Address - Country:US
Mailing Address - Phone:973-580-0650
Mailing Address - Fax:
Practice Address - Street 1:9 TOQUET ST
Practice Address - Street 2:
Practice Address - City:HASKELL
Practice Address - State:NJ
Practice Address - Zip Code:07420-1319
Practice Address - Country:US
Practice Address - Phone:973-580-0650
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-08
Last Update Date:2023-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ43ZA004311002279E1000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2279E1000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, RegisteredEducational