KENNETH EDWARD BLOOM (NPI# 1477536068) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477536068 |
| Entity Type | Individual |
| Full Name | KENNETH EDWARD BLOOM |
| Credential | M.D. |
| Practice Address |
1455 West Ave Bronx NY 10462-7304 |
| Mailing Address |
200 Central Park S Apt 107 New York NY 10019-1449 |
| Practice Telephone | 7182391500 |
| Practice Fax Number | 2127653210 |
| Mailing Telephone | 2122622500 |
| Mailing Fax Number | 2127653210 |
| Enumeration Date | 2005-11-28 |
| Last Update Date | 2019-08-22 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | 169466 | NY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 04134401 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2100 Bartow Ave Ste 211, Bronx, NY 104754614 | 7186711000 | 2127653210 |
| 2432 Grand Concourse Rm 501, Bronx, NY 104585204 | 7185375000 | 2127653210 |
| 291 E 149th St, Bronx, NY 104515601 | 7186711000 | 2127653210 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023399177 | Kenneth Joel Bloom | Pathology | 31 Columbia, Cps, Aliso Viejo, CA 92656-1460 | 2011-09-02 |
| 1326027087 | Kenneth Roland Bloom | Pediatrics | 4499 Medical Dr, Suite 272, San Antonio, TX 78229-3735 | 2006-01-11 |
| 1811983372 | Kenneth E Bloom | Podiatrist | 137 Professional Park Dr, Suite C, Mooresville, NC 28117-6540 | 2005-09-21 |
| Street Address |
1455 WEST AVE |
| City | BRONX |
| State | NY |
| Zip Code | 10462-7304 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497240675 | Angela America Libranti | Physician Assistant | 1455 West Ave, Bronx, NY 10462-7304 | 2018-06-28 |
| 1497017552 | Advanced Dermatology of New York, P.C. | Specialist | 1455 West Ave, Bronx, NY 10462-7304 | 2012-06-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629616198 | Ark Orthodontics Pllc | Dentist | 1332 Metropolitan Ave A/b, Bronx, NY 10462 | 2019-12-16 |
| 1568007714 | Afrah Saleh Abisse | Student in an Organized Health Care Education/Training Program | 715 Van Nest Ave Apt 2d, Bronx, NY 10462 | 2019-11-12 |
| 1255981486 | Angelica Cruz | Behavior Technician | 727 Morris Park Ave # 3653, Bronx, NY 10462 | 2019-09-19 |
| 1366907644 | Rebekah Rehab Assisted Living Program, Inc. | Assisted Living Facility | 1050 Havemeyer Ave, Bronx, NY 10462 | 2019-01-31 |
| 1598235467 | Windsor Leasing Corp. | Non-emergency Medical Transport (VAN) | 1598 Bronxdale Ave., Bronx, NY 10462 | 2018-12-04 |
| 1255807640 | Winchie Do | Pharmacist | 1660 Paulding Ave, Bronx, NY 10462 | 2018-10-23 |
| 1477033843 | Silva Stars Transportation | Non-emergency Medical Transport (VAN) | 2187 Cruger Ave, Suite 2d, Bronx, NY 10462 | 2018-08-15 |
| 1063926962 | Pelham Pkwy Professional Medical Services of New York LLC | Surgery | 2157 White Plains Rd Ste A, Bronx, NY 10462 | 2017-11-30 |
| 1972035749 | Kalor Riley | Occupational Therapy Assistant | 2165 Matthews Ave Apt2h, Bronx, NY 10462 | 2017-03-31 |
| 1992247472 | Jora Mgt, Corp | Non-emergency Medical Transport (VAN) | 1598 Bronxdale Ave, Bronx, NY 10462 | 2016-11-15 |
| Find all providers in zip 10462 | ||||
| Taxonomy Code | 207N00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104211580 | Shira Wieder | Dermatology | 3333 Henry Hudson Pkwy Apt 1b, Bronx, NY 10463-3235 | 2015-04-01 |
| 1508048240 | Advanced Dermatology of New York PC | Dermatology | 291 E 149th St, Bronx, NY 10451-5601 | 2007-12-05 |
| 1477689362 | Susan Katz Md | Dermatology | 1578 Williasbridge Road, Bronx, NY 10461-6265 | 2007-02-26 |
| 1225199243 | Ronald Roman Liteplo | Dermatology | 3176 Bainbridge Avenue, Bronx, NY 10467-3980 | 2006-12-13 |
| 1619075389 | Peter G Burk | Dermatology | 267a W 231st St, Bronx, NY 10463-3903 | 2006-09-20 |
| 1235124355 | Steven R Cohen | Dermatology | 111 East 210th Street, Division of Dermatology, Bronx, NY 10467-2490 | 2005-09-14 |
| 1295727808 | Eugene J Whang | Dermatology | 3620 E Tremont Ave, 2nd Floor, Bronx, NY 10465-2022 | 2005-08-19 |
| 1518964923 | Advanced Dermatology of New York PC | Dermatology | 2100 Bartow Ave, Ste 211, Bronx, NY 10475-4614 | 2005-06-30 |
| 1972917524 | Emily Hejazi | Dermatology | 111 E 210th St, Bronx, NY 10467-2401 | 2014-06-11 |
| 1134547805 | Allison Kutner | Dermatology | 111 E 210th St, Bronx, NY 10467-2401 | 2014-03-31 |
| Find all providers in BRONX | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.