Healthcare Provider Details

I. General information

NPI: 1487672234
Provider Name (Legal Business Name): ROBERT L ROSENBLATT D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/18/2006
Last Update Date: 07/06/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4 COULTER RD
CLIFTON SPRINGS NY
14432
US

IV. Provider business mailing address

360 PARRISH ST
CANANDAIGUA NY
14424-1789
US

V. Phone/Fax

Practice location:
  • Phone: 585-396-1980
  • Fax: 585-396-9509
Mailing address:
  • Phone: 585-275-1707
  • Fax: 585-396-9509

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number248630
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: