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General NPI Number Information
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NPI Number | 1639346430
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Entity Type | Organization
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Legal Business Name | PULMONARY PHYSICIANS OF LOUDOUN PLC
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Dates
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Enumeration Date | 05/12/2008
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Last Update Date | 05/03/2012
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Provider Practice Location Address
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Address Line | 44125 WOODRIDGE PKWY SUITE 100
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City | LEESBURG
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State | VA
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Zip | 20176-6839
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Country | US
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Telephone | 703-729-8222
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Fax | 703-729-8221
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Provider Business Mailing Address
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Address Line | 44125 WOODRIDGE PKWY SUITE 100
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City | LEESBURG
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State | VA
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Zip | 20176-6839
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Country | US
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Telephone | 703-729-8222
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Fax | 703-729-8221
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Authorized Official
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Title or Position | MANAGING PARTNER
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Name | DR. RICHARD ROSENTHAL
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Credential | M.D.
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Telephone | 703-729-8222
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | 0101045165
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License Number State | VA
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