Provider Demographics
NPI:1679657894
Name:ROSENBLUM, DAVID L (DC)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:L
Last Name:ROSENBLUM
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:305 CHESTNUT HILL RD
Mailing Address - Street 2:
Mailing Address - City:WOODSTOCK
Mailing Address - State:NY
Mailing Address - Zip Code:12498-2421
Mailing Address - Country:US
Mailing Address - Phone:914-389-1000
Mailing Address - Fax:845-679-4360
Practice Address - Street 1:83 MILL HILL RD
Practice Address - Street 2:
Practice Address - City:WOODSTOCK
Practice Address - State:NY
Practice Address - Zip Code:12498-1323
Practice Address - Country:US
Practice Address - Phone:845-679-2225
Practice Address - Fax:845-679-4360
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-24
Last Update Date:2022-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX003882111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYX21931Medicare ID - Type UnspecifiedMEDICARE
NYT52634Medicare UPIN