Provider Demographics
NPI:1972619351
Name:ROSENBLUM, BRET ABRAHAM (MD)
Entity type:Individual
Prefix:DR
First Name:BRET
Middle Name:ABRAHAM
Last Name:ROSENBLUM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8945 STATE ROUTE 30
Mailing Address - Street 2:
Mailing Address - City:N HUNTINGDON
Mailing Address - State:PA
Mailing Address - Zip Code:15642-2704
Mailing Address - Country:US
Mailing Address - Phone:724-861-8099
Mailing Address - Fax:
Practice Address - Street 1:8945 STATE ROUTE 30
Practice Address - Street 2:
Practice Address - City:N HUNTINGDON
Practice Address - State:PA
Practice Address - Zip Code:15642-2704
Practice Address - Country:US
Practice Address - Phone:724-861-8099
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2024-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA047425207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV1972619351Medicaid
WVWV4433AMedicare PIN