Healthcare Provider Details

I. General information

NPI: 1760791321
Provider Name (Legal Business Name): MARGARET RUTH ROSENTHALER RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/30/2010
Last Update Date: 09/30/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

43 RING ROAD
COPAKE NY
12516
US

IV. Provider business mailing address

1124 ROUTE 21
GHENT NY
12075
US

V. Phone/Fax

Practice location:
  • Phone: 518-329-7776
  • Fax: 518-329-7773
Mailing address:
  • Phone: 518-672-4253
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number422299-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: