MEDICARE: DR. JOSHUA RYAN ROSENTHAL M.D. AS OF 4/28/2023

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
1	207R00000X	Internal Medicine Physician	MD2026-0309	NM

General Provider Information

NPI Number	:	1275228454
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSHUA RYAN ROSENTHAL M.D. AS OF 4/28/2023

Provider Business Mailing Address
First Line	:	MSC10 5550 1 UNIVERSITY OF NEW MEXICO
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87131-0001
Country	:	US
Telephone Number	:	505-272-4661
Fax Number	:	505-272-0475

Provider Business Practice Location Address
First Line	:	MSC10 5550 1 UNIVERSITY OF NEW MEXICO
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87131-0001
Country	:	US
Telephone Number	:	505-272-4661
Fax Number	:	505-272-0475

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/05/2023
Last Update Date	:	05/14/2026

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