Healthcare Provider Details

I. General information

NPI: 1770012718
Provider Name (Legal Business Name): JOSHUA ROSENTHAL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/05/2017
Last Update Date: 04/29/2022
Certification Date: 04/29/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3708 5TH AVE STE 501
PITTSBURGH PA
15213-3427
US

IV. Provider business mailing address

101 PARK HILL DR
FREDERICKSBURG VA
22401-3357
US

V. Phone/Fax

Practice location:
  • Phone: 412-802-3043
  • Fax:
Mailing address:
  • Phone: 540-371-3010
  • Fax: 540-899-9821

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number0101273572
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: