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Contact Information

TANYA S BLOOM, OD
322 N AURORA ST
ITHACA, NY14850-4202
 Phone: 607-277-4749
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Vision Therapy

152WV0400X 41 Optometry
 

Optometrist

152W00000X 41 Optometry
Indicates primary specialty

NPI Profile & details for TANYA S BLOOM · (Female)

NPI # 1144750035
Status Active
Credentials OD (Doctor of Optometry)
Entity Individual
Enumeration date 06/14/2017
Last updated 05/02/2019 - About 7 years ago
Sole proprietor 1 No
Identifiers
  • CT License # 3039
  • NY License # 008632
  • NY License # 8632
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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