Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | 23121 | MS |
N | 207R00000X | Internist | 23121 | MS |
N | 111NI0900X | Internist | 23121 | MS |
NPI | 1124315742 |
---|---|
Provider Name | Dr. Claire Brabec Rosenblatt |
First Address | Jackson, MS 39216-4829 |
Second Address | Jackson, MS 39216-4829 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/07/2011 |
Last Update Date | 07/06/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
FB741473 | DEA (01) |