Bloom Psych Services LLC

Organization Active NPI Behavioral Neurology & Neuropsychiatry Physician · Stratford, CT

NPI 1760055826 · NPPES record last updated Aug 17, 2021

Key facts

NPI
1760055826
Entity type
Organization (NPI type 2)
Primary specialty
Behavioral Neurology & Neuropsychiatry Physician 2084B0040X
Legal business name
BLOOM PSYCH SERVICES LLC
Practice address
3000 Main St
Stratford, CT 06614-4939
Phone
(203) 683-0625
NPI assigned
Jul 19, 2021
Organization subpart
No

Authorized official

Name
Dr. Ananthakumar Thillainathan, MD NPI 1285900621
Title
Owner
Phone
(203) 683-0625

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Group Psychotherapy Psychologist
Group: 193400000X SINGLE SPECIALTY GROUP
103TP2701X
Behavioral Neurology & Neuropsychiatry Physician
Group: 193200000X MULTI-SPECIALTY GROUP
2084B0040X Yes

Addresses

Primary practice location

3000 Main St
Stratford, CT 06614-4939

Mailing address

3000 Main St
Stratford, CT 06614-4939
Phone (203) 683-0625

Other providers in Stratford, CT

All providers in Stratford, CT · Behavioral Neurology & Neuropsychiatry Physician in Connecticut

Sources for this page

Verify at the official NPI Registry.