Provider Demographics
NPI:1972781128
Name:ROSENBLUM, BURTON ERIK (EDD)
Entity Type:Individual
Prefix:DR
First Name:BURTON
Middle Name:ERIK
Last Name:ROSENBLUM
Suffix:
Gender:M
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3710 E 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80206-4571
Mailing Address - Country:US
Mailing Address - Phone:303-320-5621
Mailing Address - Fax:303-320-5621
Practice Address - Street 1:3710 E 5TH AVE
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80206-4571
Practice Address - Country:US
Practice Address - Phone:303-320-5621
Practice Address - Fax:303-320-5621
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-08
Last Update Date:2008-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO728103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO479438Medicare PIN