Basic Information
| Provider Information | |||||||||
| NPI: | 1871735308 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ROSENBLATT | ||||||||
| FirstName: | JONATHAN | ||||||||
| MiddleName: | ARON | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | D.P.T. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3307 TIMBERFIELD LN | ||||||||
| Address2: | |||||||||
| City: | BALTIMORE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 212084425 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4109893833 | ||||||||
| FaxNumber: | 4109461920 | ||||||||
| Practice Location | |||||||||
| Address1: | 710 S ANN ST FL 2 | ||||||||
| Address2: | |||||||||
| City: | BALTIMORE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 212313401 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4109893833 | ||||||||
| FaxNumber: | 4109461920 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/30/2009 | ||||||||
| LastUpdateDate: | 08/05/2014 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 22614 | MD | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.