Provider Demographics
NPI:1841233897
Name:ROSENTHAL, SAMUEL LEONARD (MD)
Entity Type:Individual
Prefix:DR
First Name:SAMUEL
Middle Name:LEONARD
Last Name:ROSENTHAL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:85 COLONIAL AVE
Mailing Address - Street 2:
Mailing Address - City:LARCHMONT
Mailing Address - State:NY
Mailing Address - Zip Code:10538-1620
Mailing Address - Country:US
Mailing Address - Phone:914-834-3025
Mailing Address - Fax:
Practice Address - Street 1:N.Y. HARBOR V.A. MEDICAL CENTER
Practice Address - Street 2:423 EAST 23 ST.
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010
Practice Address - Country:US
Practice Address - Phone:212-951-5976
Practice Address - Fax:212-951-3387
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY099334207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine