Provider Demographics
NPI:1275538332
Name:ROSENTHAL, NEIL STUART (MD)
Entity Type:Individual
Prefix:
First Name:NEIL
Middle Name:STUART
Last Name:ROSENTHAL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 E 15TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003-3723
Mailing Address - Country:US
Mailing Address - Phone:212-260-5060
Mailing Address - Fax:212-260-5090
Practice Address - Street 1:201 E 15TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-3723
Practice Address - Country:US
Practice Address - Phone:212-260-5060
Practice Address - Fax:212-260-5090
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-16
Last Update Date:2007-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY153624-12084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OCO 447OtherHEALTH NET
0754432002OtherCIGNA
NY01356789Medicaid
27948POtherHIP
498567OtherAETNA USHC
96D631OtherEMPIRE BCBS
NS2304OtherOXFORD
OCO 447OtherHEALTH NET
27948POtherHIP