Healthcare Provider Details

I. General information

NPI: 1265610927
Provider Name (Legal Business Name): BARBARA A. ROSENTHAL RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/05/2008
Last Update Date: 10/04/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

887 KELLUM ST
LINDENHURST NY
11757-1508
US

IV. Provider business mailing address

141 BURR RD
E NORTHPORT NY
11731-5338
US

V. Phone/Fax

Practice location:
  • Phone: 631-884-3000
  • Fax:
Mailing address:
  • Phone: 631-721-6361
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number252955-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: