Provider Demographics
NPI:1043502487
Name:ROSENBLATT, STUART IRA (PHD)
Entity Type:Individual
Prefix:DR
First Name:STUART
Middle Name:IRA
Last Name:ROSENBLATT
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:848 COUNTY ROUTE 60
Mailing Address - Street 2:
Mailing Address - City:GREENWICH
Mailing Address - State:NY
Mailing Address - Zip Code:12834-5008
Mailing Address - Country:US
Mailing Address - Phone:518-692-3158
Mailing Address - Fax:
Practice Address - Street 1:848 COUNTY ROUTE 60
Practice Address - Street 2:
Practice Address - City:GREENWICH
Practice Address - State:NY
Practice Address - Zip Code:12834-5008
Practice Address - Country:US
Practice Address - Phone:518-692-3158
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-04
Last Update Date:2011-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY09234-1103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical