Provider Demographics
NPI:1972707206
Name:ROSENBLATT, PAULA M (MD)
Entity Type:Individual
Prefix:
First Name:PAULA
Middle Name:M
Last Name:ROSENBLATT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:PAULA
Other - Middle Name:M
Other - Last Name:YELLON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:22 S GREENE STREET
Mailing Address - Street 2:S9D15B
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21201-1595
Mailing Address - Country:US
Mailing Address - Phone:410-328-6373
Mailing Address - Fax:410-328-6896
Practice Address - Street 1:22 S GREENE ST
Practice Address - Street 2:S9D15B
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201-1595
Practice Address - Country:US
Practice Address - Phone:410-328-6373
Practice Address - Fax:410-328-6896
Is Sole Proprietor?:No
Enumeration Date:2007-06-12
Last Update Date:2017-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD70537207RH0000X, 207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
No207RH0000XAllopathic & Osteopathic PhysiciansInternal MedicineHematology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD562101100Medicaid
MDS053-0088OtherCAREFIRST BC/BS
MDS053-0088OtherCAREFIRST BC/BS
MDP00877008Medicare PIN