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Phillip B Goldblatt

Psychiatry & Neurology

Allopathic & Osteopathic Physicians

79 Trumbull St, New Haven, CT 06511-3708

PECOS Enrollment

This provider is enrolled in PECOS as PHILLIP GOLDBLATT.

Based on the most recent information from CMS, provider Phillip B Goldblatt is legally eligible to order and refer claims for DME and PMD services only.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records yesterday at 12:57 PM.

Profile Details

Provider ID
1457480774
Provider Type
Individual
Full Name
Goldblatt, Phillip B
Credential
M.D.

Gender
Male
Sole Proprietor
Yes
Enumeration Date
3/4/2007
Last Updated
7/8/2007

Contact Information

Practice Location

79 Trumbull St, New Haven, CT 06511-3708

(203) 624-1624

Unlisted Fax

Mailing Location

79 Trumbull St, New Haven, CT 06511-3708

(203) 624-1624

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 2084P0800X Primary	Description Psychiatry & Neurology Allopathic & Osteopathic Physicians	License 113104 Connecticut

Phillip B Goldblatt

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Shimelman, Myer B

Enendu, Kaosoluchi

Wilson, Elizabeth M

Aram, Sepideh Sahar

Rutland, Will

Aversa, David Mathew

Jefferson, Sarah

Tylee, Daniel Steven

Bahekar, Pratik Pramod

Cahill, John