Provider Demographics
NPI:1912972332
Name:ROSENBLATT, MICHAEL PAUL (OD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:PAUL
Last Name:ROSENBLATT
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:900 17TH ST NW
Mailing Address - Street 2:SUITE 400
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20006-2501
Mailing Address - Country:US
Mailing Address - Phone:202-331-7566
Mailing Address - Fax:202-331-8533
Practice Address - Street 1:900 17TH ST NW
Practice Address - Street 2:SUITE 400
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20006-2501
Practice Address - Country:US
Practice Address - Phone:202-331-7566
Practice Address - Fax:202-331-8533
Is Sole Proprietor?:No
Enumeration Date:2006-02-20
Last Update Date:2015-10-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
DCOP653152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC700542K91Medicare ID - Type Unspecified
DCU25259Medicare UPIN