Provider Demographics
NPI:1699229864
Name:DAVID S. ROSENTHAL, DC, PLLC
Entity Type:Organization
Organization Name:DAVID S. ROSENTHAL, DC, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSENTHAL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:516-652-6205
Mailing Address - Street 1:858 WOODMERE PL
Mailing Address - Street 2:
Mailing Address - City:WOODMERE
Mailing Address - State:NY
Mailing Address - Zip Code:11598-2511
Mailing Address - Country:US
Mailing Address - Phone:516-652-6205
Mailing Address - Fax:
Practice Address - Street 1:858 WOODMERE PL
Practice Address - Street 2:
Practice Address - City:WOODMERE
Practice Address - State:NY
Practice Address - Zip Code:11598-2511
Practice Address - Country:US
Practice Address - Phone:516-652-6205
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-05
Last Update Date:2016-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty