Provider Demographics
NPI:1033574652
Name:ROSENTHAL, ALAN HOWARD (RPH)
Entity Type:Individual
Prefix:MR
First Name:ALAN
Middle Name:HOWARD
Last Name:ROSENTHAL
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:344 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WEST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06117-2526
Mailing Address - Country:US
Mailing Address - Phone:860-236-3564
Mailing Address - Fax:860-236-7053
Practice Address - Street 1:344 N MAIN ST
Practice Address - Street 2:
Practice Address - City:WEST HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06117-2526
Practice Address - Country:US
Practice Address - Phone:860-236-3564
Practice Address - Fax:860-236-7053
Is Sole Proprietor?:No
Enumeration Date:2015-12-25
Last Update Date:2015-12-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTPCT.0004188183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist