Provider Demographics
NPI:1699860221
Name:ROSENTHAL, ENID R (LHAD)
Entity Type:Individual
Prefix:MRS
First Name:ENID
Middle Name:R
Last Name:ROSENTHAL
Suffix:
Gender:F
Credentials:LHAD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 406153
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30384-1876
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2900 HEMPSTEAD TPKE
Practice Address - Street 2:SUITE 214
Practice Address - City:LEVITTOWN
Practice Address - State:NY
Practice Address - Zip Code:11756
Practice Address - Country:US
Practice Address - Phone:516-520-8736
Practice Address - Fax:516-520-9827
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2009-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY14000002706237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist