Provider Demographics
NPI:1699341222
Name:MARC J. ROSENBLATT, D.O., P.C.
Entity type:Organization
Organization Name:MARC J. ROSENBLATT, D.O., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARC
Authorized Official - Middle Name:J
Authorized Official - Last Name:ROSENBLATT
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:845-825-6383
Mailing Address - Street 1:983 HAVERSTRAW RD
Mailing Address - Street 2:
Mailing Address - City:SUFFERN
Mailing Address - State:NY
Mailing Address - Zip Code:10901-2200
Mailing Address - Country:US
Mailing Address - Phone:845-825-6383
Mailing Address - Fax:
Practice Address - Street 1:873 N MAIN ST # 102
Practice Address - Street 2:
Practice Address - City:SPRING VALLEY
Practice Address - State:NY
Practice Address - Zip Code:10977-1905
Practice Address - Country:US
Practice Address - Phone:845-521-1542
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-03
Last Update Date:2021-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain MedicineGroup - Single Specialty