Provider Demographics
NPI:1083785638
Name:ROSENBLATT, WILLIAM PAUL (EDD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:PAUL
Last Name:ROSENBLATT
Suffix:
Gender:M
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2002 SUNSET AVE
Mailing Address - Street 2:
Mailing Address - City:OCEAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07712-4674
Mailing Address - Country:US
Mailing Address - Phone:732-775-2960
Mailing Address - Fax:732-774-0675
Practice Address - Street 1:2002 SUNSET AVE
Practice Address - Street 2:
Practice Address - City:OCEAN
Practice Address - State:NJ
Practice Address - Zip Code:07712-4674
Practice Address - Country:US
Practice Address - Phone:732-775-2960
Practice Address - Fax:732-774-0675
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35S100254800103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2066017OtherAETNA
NJ0483502000OtherAMERIHEALTH
NJV5086OtherOXFORD INSURANCE