Provider Demographics
NPI:1558329748
Name:ROSENBLUM, DONALD Z (MD)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:Z
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:PO BOX 7247-6822
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19170-0001
Mailing Address - Country:US
Mailing Address - Phone:914-241-1050
Mailing Address - Fax:914-242-1516
Practice Address - Street 1:1561 RTE 9W
Practice Address - Street 2:
Practice Address - City:LAKE KATRINE
Practice Address - State:NY
Practice Address - Zip Code:12449-5410
Practice Address - Country:US
Practice Address - Phone:845-231-5600
Practice Address - Fax:845-231-5489
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2016-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY121300208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00502016Medicaid
NYB12636Medicare UPIN
NY00502016Medicaid