Provider Demographics
NPI:1104148378
Name:ROSENBLOOM, MURRAY (RPH)
Entity type:Individual
Prefix:
First Name:MURRAY
Middle Name:
Last Name:ROSENBLOOM
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:503 NORTHWEST DR
Mailing Address - Street 2:
Mailing Address - City:FARMINGDALE
Mailing Address - State:NY
Mailing Address - Zip Code:11735-4940
Mailing Address - Country:US
Mailing Address - Phone:516-755-5762
Mailing Address - Fax:516-755-0884
Practice Address - Street 1:503 NORTHWEST DR
Practice Address - Street 2:
Practice Address - City:FARMINGDALE
Practice Address - State:NY
Practice Address - Zip Code:11735-4940
Practice Address - Country:US
Practice Address - Phone:516-755-5762
Practice Address - Fax:516-755-0884
Is Sole Proprietor?:No
Enumeration Date:2010-02-15
Last Update Date:2010-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY024464-1183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist