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General NPI Number Information
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NPI Number | 1104830975
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Entity Type | Organization
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Legal Business Name | DONALD G ROSENTHAL MD
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Dates
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Enumeration Date | 07/28/2006
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Last Update Date | 12/03/2007
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Provider Practice Location Address
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Address Line | 447 MERIDEN RD
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City | WATERBURY
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State | CT
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Zip | 06705
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Country | US
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Telephone | 203-574-5650
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Fax | 203-574-7815
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Provider Business Mailing Address
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Address Line | 447 MERIDEN RD
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City | WATERBURY
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State | CT
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Zip | 06705
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Country | US
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Telephone | 203-574-5650
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Fax | 203-574-7815
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Authorized Official
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Title or Position | OWNER PHYSICIAN
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Name | DR. DONALD G ROSENTHAL
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Credential | MD
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Telephone | 203-574-5650
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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