Basic Information
| Provider Information | |||||||||
| NPI: | 1861452468 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ROSENBLATT | ||||||||
| FirstName: | ROBERT | ||||||||
| MiddleName: | M | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 49 CARSTEAD DR | ||||||||
| Address2: | |||||||||
| City: | SLINGERLANDS | ||||||||
| State: | NY | ||||||||
| PostalCode: | 121599267 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5184395492 | ||||||||
| FaxNumber: | 5184394018 | ||||||||
| Practice Location | |||||||||
| Address1: | 49 CARSTEAD DR | ||||||||
| Address2: | |||||||||
| City: | SLINGERLANDS | ||||||||
| State: | NY | ||||||||
| PostalCode: | 121599267 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5184395492 | ||||||||
| FaxNumber: | 5184394018 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/27/2006 | ||||||||
| LastUpdateDate: | 01/12/2009 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207VG0400X | 091473 | NY | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Gynecology |
ID Information
| ID | Type | State | Issuer | Description | 00517937 | 05 | NY | MEDICAID |