Provider Demographics
NPI:1902950140
Name:ROSENBLUM, GIANINE DENISE (PHD)
Entity Type:Individual
Prefix:DR
First Name:GIANINE
Middle Name:DENISE
Last Name:ROSENBLUM
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:133 FRANKLIN CORNER RD
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08648-2531
Mailing Address - Country:US
Mailing Address - Phone:609-406-1754
Mailing Address - Fax:609-406-9319
Practice Address - Street 1:133 FRANKLIN CORNER RD
Practice Address - Street 2:2ND FLOOR
Practice Address - City:LAWRENCEVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08648-2531
Practice Address - Country:US
Practice Address - Phone:609-406-1754
Practice Address - Fax:609-406-9319
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-23
Last Update Date:2011-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35SI00374900103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical