Provider Demographics
NPI:1336202274
Name:ROSENBLATT FAMILY EYECARE ASSOCIATES, PA
Entity Type:Organization
Organization Name:ROSENBLATT FAMILY EYECARE ASSOCIATES, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:D
Authorized Official - Last Name:ROSENBLATT
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:908-725-3331
Mailing Address - Street 1:80 E SOMERSET ST
Mailing Address - Street 2:
Mailing Address - City:RARITAN
Mailing Address - State:NJ
Mailing Address - Zip Code:08869-2113
Mailing Address - Country:US
Mailing Address - Phone:908-725-3331
Mailing Address - Fax:908-725-3237
Practice Address - Street 1:80 E SOMERSET ST
Practice Address - Street 2:
Practice Address - City:RARITAN
Practice Address - State:NJ
Practice Address - Zip Code:08869-2113
Practice Address - Country:US
Practice Address - Phone:908-725-3331
Practice Address - Fax:908-725-3237
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-19
Last Update Date:2009-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ4986152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact ManagementGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ6195105Medicaid
NJ6195105Medicaid
NJU01588Medicare UPIN
NJU47409Medicare UPIN
NJ1312630001Medicare NSC