Individual
MORDECHAY ROSENBLUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
C.O
Contact information
Practice address
2689 E 14TH ST, BROOKLYN, NY 11235-3915
(718) 368-1855
Mailing address
2689 E 14TH ST, BROOKLYN, NY 11235-3915
(718) 368-1855
Taxonomy
Speciality
Code
Description
License number
State
222Z00000X
Orthotist
45PO00005100
NJ
222Z00000X
Orthotist
Primary
CO1917
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01175933
—
NY
Enumeration date
03/02/2007
Last updated
12/12/2007
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