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
- Title
- Owner
- Phone
- (203) 683-0625
Practitioners 1
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Group Psychotherapy Psychologist |
103TP2701X | |||
| Behavioral Neurology & Neuropsychiatry Physician |
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
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 17, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.