Provider Demographics
NPI:1073714150
Name:ROSENBLATT, SHARI TRUDY (CSW)
Entity Type:Individual
Prefix:MS
First Name:SHARI
Middle Name:TRUDY
Last Name:ROSENBLATT
Suffix:
Gender:F
Credentials:CSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:144 W 27TH ST
Mailing Address - Street 2:SUITE 10R
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10001-6214
Mailing Address - Country:US
Mailing Address - Phone:212-255-5795
Mailing Address - Fax:212-255-5795
Practice Address - Street 1:144 W 27TH ST
Practice Address - Street 2:SUTE 10R
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-6214
Practice Address - Country:US
Practice Address - Phone:212-255-5795
Practice Address - Fax:212-255-5795
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-29
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY028935SR1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYN24861SRMedicare UPIN