Healthcare Provider Details

I. General information

NPI: 1659356657
Provider Name (Legal Business Name): STUART A ROSENTHAL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/13/2005
Last Update Date: 09/24/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

171 RAMAPO RD
GARNERVILLE NY
10923
US

IV. Provider business mailing address

171 RAMAPO RD
GARNERVILLE NY
10923
US

V. Phone/Fax

Practice location:
  • Phone: 845-947-2240
  • Fax: 845-947-2265
Mailing address:
  • Phone: 845-947-2240
  • Fax: 845-947-2265

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number090757
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: