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Contact Information

LARRY M BLOOM, OD
5600 MONROE ST
SYLVANIA, OH43560
 Phone: 419-882-8467
 Fax: 419-882-8951
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Optometrist

152W00000X 41 Optometry
Indicates primary specialty

NPI Profile & details for LARRY M BLOOM · (Male)

NPI # 1144400763
Status Active
Credentials OD (Doctor of Optometry)
Entity Individual
Enumeration date 11/12/2007
Last updated 03/09/2009 - About 17 years ago
Sole proprietor 1 Yes
Identifiers
  • OH License # 2757/T1242
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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