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NPI Code Detail

MEDICARE: DEVORAH ROSENTHAL

MEDICARE:   DEVORAH  ROSENTHAL
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1174400000XSpecialist

General Provider Information

NPI Number : 1023433802
Entity Type Code : Individual
Provider Name (Legal Business Name) : DEVORAH ROSENTHAL
Provider Business Mailing Address
First Line : 1649 BARRYMOR DR
Second Line :
City : LAKEWOOD
State : NJ
Zip : 08701-3905
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1649 BARRYMOR DR
Second Line :
City : LAKEWOOD
State : NJ
Zip : 08701-3905
Country : US
Telephone Number : 732-987-4565
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/03/2014
Last Update Date : 03/03/2014

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Directions to “ DEVORAH ROSENTHAL ” Practice Location

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