Provider Demographics
NPI:1700815149
Name:ROSENBLUM, RICHARD BRYAN (MA, MS, ATC)
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:BRYAN
Last Name:ROSENBLUM
Suffix:
Gender:M
Credentials:MA, MS, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:92 HERON CT
Mailing Address - Street 2:MANALAPAN
Mailing Address - City:ENGLISHTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07726-9018
Mailing Address - Country:US
Mailing Address - Phone:732-851-6136
Mailing Address - Fax:
Practice Address - Street 1:260 TRIANGLE RD
Practice Address - Street 2:
Practice Address - City:HILLSBOROUGH
Practice Address - State:NJ
Practice Address - Zip Code:08844-4878
Practice Address - Country:US
Practice Address - Phone:908-874-3420
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ9154742255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer