Healthcare Provider Details

I. General information

NPI: 1306257746
Provider Name (Legal Business Name): AMBER ROSENTHAL NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/19/2014
Last Update Date: 09/26/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

215 E 95TH ST
NEW YORK NY
10128-4077
US

IV. Provider business mailing address

55 WATER STREET 2ND FLOOR CRED DEPT
NEW YORK NY
10041-0004
US

V. Phone/Fax

Practice location:
  • Phone: 212-996-8000
  • Fax: 212-423-3127
Mailing address:
  • Phone: 646-680-2888
  • Fax: 516-542-5556

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number683821
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number341917
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: