Healthcare Provider Details

I. General information

NPI: 1669461976
Provider Name (Legal Business Name): BRUCE ROSENTHAL
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/19/2005
Last Update Date: 03/25/2021
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 LOCUST ST
PITTSBURGH PA
15219-5114
US

IV. Provider business mailing address

2 HOT METAL ST QUANTUM ONE - SUITE 001
PITTSBURGH PA
15203-2348
US

V. Phone/Fax

Practice location:
  • Phone: 412-232-8222
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0204X
TaxonomyPediatric Emergency Medicine (Pediatrics) Physician
License NumberMD024898E
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: