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Contact Information

DENNIS BLOM, MD
2202 GENESEE ST
UTICA, NY13502
 Phone: 315-732-0349
 Fax: 315-732-0309
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Surgery

208600000X 02 Physician/General Surgery
Indicates primary specialty

NPI Profile & details for DENNIS BLOM · (Male)

NPI Number 1376501940
Status Active
Credentials MD
Entity Individual
Enumeration date 05/03/2006
Last updated 09/11/2018 - About 8 years ago
Sole proprietor 1 Yes
Identifiers
  • IN License # 1060363A
  • NY License # 196361
  • NY Medicaid 03107559
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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