Provider Demographics
NPI:1538502935
Name:ROSENBLUM, MERYL (MS, CCC)
Entity Type:Individual
Prefix:MS
First Name:MERYL
Middle Name:
Last Name:ROSENBLUM
Suffix:
Gender:F
Credentials:MS, CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1930 ROUTE 70 E
Mailing Address - Street 2:BUILDING E, SUITE 30
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08003-2150
Mailing Address - Country:US
Mailing Address - Phone:856-489-5787
Mailing Address - Fax:856-489-5799
Practice Address - Street 1:1930 ROUTE 70 E
Practice Address - Street 2:BUILDING E, SUITE 30
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08003-2150
Practice Address - Country:US
Practice Address - Phone:856-489-5787
Practice Address - Fax:856-489-5799
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-16
Last Update Date:2013-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS00256200235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist