Provider Demographics
NPI:1225093586
Name:ROSENBLUM, MINDY FLEISCHER (MD)
Entity Type:Individual
Prefix:DR
First Name:MINDY
Middle Name:FLEISCHER
Last Name:ROSENBLUM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:402 LIPPINCOTT DR
Mailing Address - Street 2:
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-4112
Mailing Address - Country:US
Mailing Address - Phone:856-782-3300
Mailing Address - Fax:856-504-8029
Practice Address - Street 1:701 MONTGOMERY AVE
Practice Address - Street 2:SUITE 18
Practice Address - City:NARBERTH
Practice Address - State:PA
Practice Address - Zip Code:19072
Practice Address - Country:US
Practice Address - Phone:610-642-9200
Practice Address - Fax:610-649-4723
Is Sole Proprietor?:No
Enumeration Date:2006-04-19
Last Update Date:2010-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD022025E208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
077356 SK3Medicare PIN