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Contact Information

JERRY M BLOOMSTEIN, MD
1220 DEWEY AVE
BLDG 2
WAUWATOSA, WI53213-2504
 Phone: 414-454-6500
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Child & Adolescent Psychiatry

2084P0804X 86 Physician/Neuropsychiatry
Indicates primary specialty

NPI Profile & details for JERRY M BLOOMSTEIN · (Male)

NPI Number 1356475594
Status Active
Credentials MD
Entity Individual
Enumeration date 03/16/2007
Last updated 11/23/2021 - About 5 years ago
Sole proprietor 1 No
Identifiers
  • WI License # 28817
  • WI Medicaid 31465900
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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