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General NPI Number Information
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NPI Number | 1083751598
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Entity Type | Organization
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Legal Business Name | BRUCE R. ROSENBLUM, MD PC
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Dates
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Enumeration Date | 01/31/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 160 AVENUE OF THE CMN
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City | SHREWSBURY
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State | NJ
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Zip | 07702-4802
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Country | US
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Telephone | 732-460-1522
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Fax | 732-460-1529
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Provider Business Mailing Address
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Address Line | PO BOX 159
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City | COLTS NECK
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State | NJ
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Zip | 07722-0159
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Country | US
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Telephone | 732-460-1522
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Fax | 732-460-1529
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. BRUCE R ROSENBLUM
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Credential | M.D.
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Telephone | 732-460-1522
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207T00000X
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Taxonomy Name | Neurological Surgery Physician
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License Number | 25MA05714300
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License Number State | NJ
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