Provider Demographics
NPI:1861452468
Name:ROSENBLATT, ROBERT M (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:M
Last Name:ROSENBLATT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:49 CARSTEAD DR
Mailing Address - Street 2:
Mailing Address - City:SLINGERLANDS
Mailing Address - State:NY
Mailing Address - Zip Code:12159-9267
Mailing Address - Country:US
Mailing Address - Phone:518-439-5492
Mailing Address - Fax:518-439-4018
Practice Address - Street 1:49 CARSTEAD DR
Practice Address - Street 2:
Practice Address - City:SLINGERLANDS
Practice Address - State:NY
Practice Address - Zip Code:12159-9267
Practice Address - Country:US
Practice Address - Phone:518-439-5492
Practice Address - Fax:518-439-4018
Is Sole Proprietor?:No
Enumeration Date:2006-03-27
Last Update Date:2009-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY091473207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00517937Medicaid
NY00517937Medicaid
NYCC5863Medicare ID - Type Unspecified