Provider Demographics
NPI:1477651461
Name:ROSENTHAL, ANDREA JOY (MD)
Entity Type:Individual
Prefix:DR
First Name:ANDREA
Middle Name:JOY
Last Name:ROSENTHAL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:88 WESSON TER
Mailing Address - Street 2:
Mailing Address - City:NORTHBOROUGH
Mailing Address - State:MA
Mailing Address - Zip Code:01532-1960
Mailing Address - Country:US
Mailing Address - Phone:508-393-2913
Mailing Address - Fax:508-792-7900
Practice Address - Street 1:500 COLONY RD
Practice Address - Street 2:
Practice Address - City:GARDNER
Practice Address - State:MA
Practice Address - Zip Code:01440-4238
Practice Address - Country:US
Practice Address - Phone:978-630-6050
Practice Address - Fax:508-792-7900
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA76811174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist