Provider Demographics
NPI:1073604971
Name:RICHARD R. ROSENTHAL, MD, LTD
Entity Type:Organization
Organization Name:RICHARD R. ROSENTHAL, MD, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:R
Authorized Official - Last Name:ROSENTHAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:703-573-4440
Mailing Address - Street 1:8318 ARLINGTON BLVD
Mailing Address - Street 2:SUITE #308
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22031-5218
Mailing Address - Country:US
Mailing Address - Phone:703-573-4440
Mailing Address - Fax:703-280-4650
Practice Address - Street 1:8318 ARLINGTON BLVD
Practice Address - Street 2:SUITE #308
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22031-5218
Practice Address - Country:US
Practice Address - Phone:703-573-4440
Practice Address - Fax:703-280-4650
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-27
Last Update Date:2007-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA207KA0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA475425Medicare PIN