Sandra L. Bloom

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

MD019329E Issued in PA

Practice address

13 Druim Moir LN
Philadelphia, PA 19118-4134

Phone

(215) 248-5357

Fax

(215) 248-5367

NPI assigned

Sep 21, 2009

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Sandra Lynn Treen Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1253491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1253491200000",
    "number": "1750615068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13 DRUIM MOIR LN",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191184134",
            "telephone_number": "215-248-5357",
            "fax_number": "215-248-5367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13 DRUIM MOIR LN",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191184134",
            "telephone_number": "215-248-5357",
            "fax_number": "215-248-5367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLOOM",
        "first_name": "SANDRA",
        "middle_name": "L.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-09-21",
        "last_updated": "2009-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "PA",
            "license": "MD019329E",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SANDRA",
            "last_name": "TREEN",
            "middle_name": "LYNN",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Lauren Christine Bloom
• Lawrence Bloom, M.D.
• Linda Bloom, LCSW
• Robert Wesley Bloom, MD
• Roy D Bloom, MD
• Bloomgarden & Associates (Bloomgarden Ostroff & Associates)
• Andrea L Bloomgarden, PH D
• Blooming Hart Wellness LLC (Blooming Hart Wellness)
• Bloomingu Home Care, LLC.
• Caroline Bloss, CRNP

• Psychiatry Physician in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Psychiatry Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2009; 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.