Provider Demographics
NPI:1881372357
Name:BLOOM, ZACHARY ELIAS (DO)
Entity type:Individual
Prefix:DR
First Name:ZACHARY
Middle Name:ELIAS
Last Name:BLOOM
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:597 PARK AVE STE B
Mailing Address - Street 2:
Mailing Address - City:FREEHOLD
Mailing Address - State:NJ
Mailing Address - Zip Code:07728-2590
Mailing Address - Country:US
Mailing Address - Phone:732-294-2540
Mailing Address - Fax:
Practice Address - Street 1:597 PARK AVE STE B
Practice Address - Street 2:
Practice Address - City:FREEHOLD
Practice Address - State:NJ
Practice Address - Zip Code:07728-2590
Practice Address - Country:US
Practice Address - Phone:732-294-2540
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-06
Last Update Date:2023-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program