Robin Beth Bloom, R.D.

Individual provider Active NPI Registered Dietitian · Northport, NY

NPI 1043322258 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1043322258
Entity type
Individual (NPI type 1)
Primary specialty
Registered Dietitian 133V00000X
Practice address
79 Middleville Rd
Northport, NY 11768-2200
Phone
(631) 261-4400
Fax
(631) 266-6018
NPI assigned
Sep 1, 2006
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X Yes

Addresses

Primary practice location

79 Middleville Rd
Northport, NY 11768-2200

Mailing address

79 Middleville Rd
Northport, NY 11768-2200
Phone (631) 261-4400

Other providers in Northport, NY

All providers in Northport, NY · Registered Dietitian in New York

Sources for this page

Verify at the official NPI Registry.