Provider Demographics
NPI:1053331181
Name:ROSENBLUM, MARTIN (MD)
Entity Type:Individual
Prefix:
First Name:MARTIN
Middle Name:
Last Name:ROSENBLUM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7365 MAIN ST
Mailing Address - Street 2:BRIDGEPORT ANESTHESIA ASSOCIATES, P.C.
Mailing Address - City:STRATFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06614-1300
Mailing Address - Country:US
Mailing Address - Phone:203-384-3174
Mailing Address - Fax:
Practice Address - Street 1:267 GRANT ST
Practice Address - Street 2:BRIDGEPORT ANESTHESIA ASSOCIATES, P.C.
Practice Address - City:BRIDGEPORT
Practice Address - State:CT
Practice Address - Zip Code:06610-2805
Practice Address - Country:US
Practice Address - Phone:203-384-3072
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2009-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT23701207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT500HBA011CT01OtherBCBS CT
CTCHN1163OtherCOMMUNITY HEALTH NETWORK
CT1237015Medicaid
CT500HBA011CT01OtherBLUE CARE FAMILY PLAN
CT4305520OtherAETNA CT
CT95012OtherHEALTH NET
CTA770995OtherOXFORD HEALTH PLANS
CT060855634003OtherCIGNA CT
CT755634OtherCONNECTICARE
CTCHN1163OtherCOMMUNITY HEALTH NETWORK
CT1237015Medicaid