Healthcare Provider Details

I. General information

NPI: 1023345444
Provider Name (Legal Business Name): JEFFREY LEE ROSENBLUM, MD, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/05/2009
Last Update Date: 11/05/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

80 W WELSH POOL RD SUITE 100
EXTON PA
19341-1233
US

IV. Provider business mailing address

80 W WELSH POOL RD SUITE 100
EXTON PA
19341-1233
US

V. Phone/Fax

Practice location:
  • Phone: 610-524-5444
  • Fax: 610-524-5443
Mailing address:
  • Phone: 610-524-5444
  • Fax: 610-524-5443

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: JEFFREY L ROSENBLUM
Title or Position: OWNER
Credential: MD
Phone: 610-524-5444