Individual
DR. JENNIFER LEIGH ROSENBLUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
40 2ND AVE STE 300, MGH WEST, WALTHAM, MA 02451-1136
(617) 643-1201
(617) 243-6798
Mailing address
PO BOX 9142, MASS GENERAL PHYSICIAN ORGANIZATION, CHARLESTOWN, MA 02129-9142
(617) 643-1201
(617) 724-1201
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
209839
MA
207RA0000X
Adolescent Medicine (Internal Medicine) Physician
Primary
209839
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0197629
—
MA
01
—
209839
TUFTS HEALTH PLAN
MA
01
—
J25140
BCBS MA
MA
Enumeration date
05/15/2006
Last updated
10/30/2012
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