Healthcare Provider Details

I. General information

NPI: 1679657894
Provider Name (Legal Business Name): DAVID L. ROSENBLUM D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/24/2006
Last Update Date: 10/27/2022
Certification Date: 10/27/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

83 MILL HILL RD
WOODSTOCK NY
12498-1323
US

IV. Provider business mailing address

305 CHESTNUT HILL RD
WOODSTOCK NY
12498-2421
US

V. Phone/Fax

Practice location:
  • Phone: 845-679-2225
  • Fax: 845-679-4360
Mailing address:
  • Phone: 914-389-1000
  • Fax: 845-679-4360

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberX003882
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: