Provider Demographics
NPI:1174978597
Name:BLOOM, ALANA (DC)
Entity type:Individual
Prefix:
First Name:ALANA
Middle Name:
Last Name:BLOOM
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:81 MONTGOMERY BLVD
Mailing Address - Street 2:
Mailing Address - City:ATLANTIC BEACH
Mailing Address - State:NY
Mailing Address - Zip Code:11509-1412
Mailing Address - Country:US
Mailing Address - Phone:516-220-5196
Mailing Address - Fax:
Practice Address - Street 1:39 WEST 56TH STREET
Practice Address - Street 2:FLOOR #4
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019
Practice Address - Country:US
Practice Address - Phone:646-512-7110
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-04
Last Update Date:2025-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX012831-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor