Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Evan Bloom, MD

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1760171607

Evan Bloom, MD is a Student in an Organized Health Care Education/Training Program in Mineola, New York. Practices as a sole proprietor. Registered with an NPI since 2023.

In the registry since
2023
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

259 1st St
Mineola, NY 11501-3957
Phone: (516) 663-0333
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Student in an Organized Health Care Education/Training Program (primary) Taxonomy 390200000X

Record details

NPI number1760171607
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorYes
NPI enumeratedMay 5, 2023
Last updated in NPPESMay 5, 2023
Certification dateMay 5, 2023
Mailing address259 1st St, Mineola, NY 11501-3957

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