Larry M. Bloom OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

2757/T1242 Issued in OH

Legal business name

LARRY M. BLOOM OD

Practice address

5600 Monroe St Ste 102
Sylvania, OH 43560-2731

Phone

(419) 882-8467

Fax

(419) 882-8951

NPI assigned

Aug 8, 2006

Last updated

Nov 19, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Kelli J Schultz

Title

Office Manager

Phone

(419) 882-8467

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1195430400000",
    "number": "1952310773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5600 MONROE ST",
            "city": "SYLVANIA",
            "state": "OH",
            "postal_code": "435602731",
            "telephone_number": "419-882-8467",
            "fax_number": "419-882-8951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5600 MONROE ST STE 102",
            "city": "SYLVANIA",
            "state": "OH",
            "postal_code": "435602731",
            "telephone_number": "419-882-8467",
            "fax_number": "419-882-8951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LARRY M. BLOOM OD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-08",
        "last_updated": "2007-11-19",
        "status": "A",
        "authorized_official_last_name": "SCHULTZ",
        "authorized_official_first_name": "KELLI",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "419-882-8467",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "2757/T1242",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Danine T Lajiness-Polosky, APRN-B.C., PMHNP
• Shane Smith Lakatos
• Lane Drug Co (Rite Aid Pharmacy 02341)
• Lane Drug Co (Rite Aid Pharmacy 02354)
• Shelby Lane
• Dominique Lash, M.D.
• Nicole Renee Lasich
• Dev Laungani
• Cornell Lawrence
• LBL Home Care, Inc. (ComForcare Senior Services)

• Optometrist in Sylvania, OH
• Providers in Sylvania, OH by specialty
• Optometrist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2007; 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.