Liza V Bloom, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

729142 Issued in NY

Practice address

20 Old Turnpike Rd Ste 307
Nanuet, NY 10954-2530

Phone

(845) 624-0260

NPI assigned

Aug 14, 2019

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1565740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632096000000",
    "number": "1174179204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1617",
            "city": "GREENWOOD LAKE",
            "state": "NY",
            "postal_code": "109251617",
            "telephone_number": "845-754-3242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 OLD TURNPIKE RD STE 307",
            "city": "NANUET",
            "state": "NY",
            "postal_code": "109542530",
            "telephone_number": "845-624-0260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLOOM",
        "first_name": "LIZA",
        "middle_name": "V",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-14",
        "last_updated": "2021-09-20",
        "certification_date": "2021-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "729142",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "729142",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nenita Binas
• Blaze Physical Therapy PLLC
• Tyneadrian Bledsoe
• Erica Blehl, O.D.
• Paul K Blood
• Jeanine Marie Blumenfeld, LCSW
• Glen H Blustein, OD
• Gail S Bock-Frankel, P.T
• Larry S Borakove, PHD
• Leah Bowers, RN

• Registered Nurse in Nanuet, NY
• Providers in Nanuet, NY by specialty
• Registered Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.