Provider Demographics
NPI:1265689426
Name:ROSENBLATT, PENELOPE ANN (LCSW)
Entity Type:Individual
Prefix:MS
First Name:PENELOPE
Middle Name:ANN
Last Name:ROSENBLATT
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3636 GREYSTONE AVE
Mailing Address - Street 2:APT 3 E
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10463-2018
Mailing Address - Country:US
Mailing Address - Phone:718-796-3730
Mailing Address - Fax:
Practice Address - Street 1:3636 GREYSTONE AVE
Practice Address - Street 2:APT 3 E
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10463-2018
Practice Address - Country:US
Practice Address - Phone:718-796-3730
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-19
Last Update Date:2008-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR03227011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical