Healthcare Provider Details

I. General information

NPI: 1316130875
Provider Name (Legal Business Name): STEVE ROSENTHAL DC, L.AC., CA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/19/2007
Last Update Date: 06/15/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1005 WASHINGTON BLVD WASHINGTON WELLNESS CENTER
ROBBINSVILLE NJ
08691-3119
US

IV. Provider business mailing address

1005 WASHINGTON BLVD WASHINGTON WELLNESS CENTER
ROBBINSVILLE NJ
08691-3119
US

V. Phone/Fax

Practice location:
  • Phone: 609-426-1700
  • Fax: 609-426-0099
Mailing address:
  • Phone: 609-426-1700
  • Fax: 609-426-0099

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number002192
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number908
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number275
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: