Provider Demographics
NPI:1720176662
Name:ROSENBLATT, RUBEN DORIAN (PHD)
Entity Type:Individual
Prefix:DR
First Name:RUBEN
Middle Name:DORIAN
Last Name:ROSENBLATT
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:94 BECHSTEIN DR
Mailing Address - Street 2:
Mailing Address - City:MATAWAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07747-2336
Mailing Address - Country:US
Mailing Address - Phone:908-902-9984
Mailing Address - Fax:
Practice Address - Street 1:196 MAIN ST
Practice Address - Street 2:
Practice Address - City:MATAWAN
Practice Address - State:NJ
Practice Address - Zip Code:07747-3173
Practice Address - Country:US
Practice Address - Phone:908-902-9984
Practice Address - Fax:732-290-0311
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35SI00330900103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical