Provider Demographics
NPI:1043246952
Name:ROSENBLATT, BETH R (OD)
Entity Type:Individual
Prefix:DR
First Name:BETH
Middle Name:R
Last Name:ROSENBLATT
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:80 E SOMERSET ST
Mailing Address - Street 2:
Mailing Address - City:RARITAN
Mailing Address - State:NJ
Mailing Address - Zip Code:08869-2113
Mailing Address - Country:US
Mailing Address - Phone:908-725-3331
Mailing Address - Fax:908-725-3237
Practice Address - Street 1:1 DIAMOND HILL RD
Practice Address - Street 2:
Practice Address - City:BERKELEY HEIGHTS
Practice Address - State:NJ
Practice Address - Zip Code:07922-2104
Practice Address - Country:US
Practice Address - Phone:908-277-8682
Practice Address - Fax:908-277-8694
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2018-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ27TO00009700152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ447409Medicare UPIN