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NPI Code Detail

MEDICARE: MARK A. ROSENTHAL M.D.

MEDICARE: MARK A. ROSENTHAL M.D.
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
1208000000XPediatrics Physician037353CT

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
101037353OTHERCIGNA
2OV5871OTHERHEALTH NET
3010037353CT0OTHERBLUE CROSS
4761223OTHERCONNECTICARE
5MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
61204724OTHERUNITED HEALTH CARE

General Provider Information

NPI Number : 1144319690
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARK A. ROSENTHAL M.D.
Provider Business Mailing Address
First Line : 1527 ROUTE 12
Second Line : PO BOX 608
City : GALES FERRY
State : CT
Zip : 06335-1800
Country : US
Telephone Number : 860-464-7248
Fax Number : 860-464-0125
Provider Business Practice Location Address
First Line : 1527 ROUTE 12
Second Line : BOX 608
City : GALES FERRY
State : CT
Zip : 06335-1800
Country : US
Telephone Number : 860-464-7248
Fax Number : 860-464-0125
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/12/2006
Last Update Date : 01/22/2013

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Directions to “ MARK A. ROSENTHAL M.D.” Practice Location

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