Provider Demographics
NPI:1861047193
Name:BFPS PC
Entity type:Organization
Organization Name:BFPS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:BLOOM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:215-900-2806
Mailing Address - Street 1:2 TOWN PL STE 110
Mailing Address - Street 2:
Mailing Address - City:BRYN MAWR
Mailing Address - State:PA
Mailing Address - Zip Code:19010-3420
Mailing Address - Country:US
Mailing Address - Phone:610-762-5666
Mailing Address - Fax:
Practice Address - Street 1:2 TOWN PL STE 110
Practice Address - Street 2:
Practice Address - City:BRYN MAWR
Practice Address - State:PA
Practice Address - Zip Code:19010-3420
Practice Address - Country:US
Practice Address - Phone:215-900-2806
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-04
Last Update Date:2021-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207YS0123XAllopathic & Osteopathic PhysiciansOtolaryngologyFacial Plastic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA9547626OtherAETNA
PA3845396000OtherBLUE CROSS BLUE SHIELD OF PA / PERSONAL CHOICE / KEYSTONE HEALTH PLAN EAST
PA834539600OtherAMERIHEALTH
PA2075855OtherCIGNA
PA003201614-003OtherUNITEDHEALTHCARE