Provider Demographics
NPI:1235247859
Name:ROSENBLUM, HARVEY (MD)
Entity Type:Individual
Prefix:DR
First Name:HARVEY
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 1:220 MADISON AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-3422
Mailing Address - Country:US
Mailing Address - Phone:212-683-7330
Mailing Address - Fax:212-683-1947
Practice Address - Street 1:220 MADISON AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-3422
Practice Address - Country:US
Practice Address - Phone:212-683-7330
Practice Address - Fax:212-683-1947
Is Sole Proprietor?:No
Enumeration Date:2006-08-25
Last Update Date:2008-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY142591207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00766629Medicaid
NY00766629Medicaid
NY93A812Medicare PIN
NY93A811Medicare PIN
NYHR093A8110Medicare PIN
NYB20235Medicare UPIN
NYHR093A8120Medicare UPIN
NY0899050001Medicare PIN