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General NPI Number Information
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NPI Number | 1922086214
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Entity Type | Individual
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Provider Name | MINDY H ROSENTHAL C.N., R.D.
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Gender | Female
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Dates
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Enumeration Date | 01/06/2006
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Last Update Date | 06/29/2016
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Provider Practice Location Address
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Address Line | 7030 173RD ST
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City | FLUSHING
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State | NY
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Zip | 11365-3450
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Country | US
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Telephone | 718-591-6321
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Fax | 718-591-6321
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Provider Business Mailing Address
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Address Line | 7030 173RD ST
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City | FLUSHING
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State | NY
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Zip | 11365-3450
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Country | US
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Telephone | 718-591-6321
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Fax | 718-591-6321
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133N00000X
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Taxonomy Name | Nutritionist
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License Number | 000745
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | 716993
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License Number State | NY
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