Healthcare Provider Details
I. General information
NPI: 1235394826
Provider Name (Legal Business Name): LAUREN B ROSENTHAL MD, MPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/23/2008
Last Update Date: 07/23/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
100 MADISON AVE
MORRISTOWN NJ
07960-6136
US
IV. Provider business mailing address
100 MADISON AVE
MORRISTOWN NJ
07960-6136
US
V. Phone/Fax
- Phone: 973-971-5996
- Fax: 973-290-7979
- Phone: 973-971-5996
- Fax: 973-290-7979
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2080P0202X |
| Taxonomy | Pediatric Cardiology Physician |
| License Number | 25MA08412300 |
| License Number State | NJ |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: