Provider Demographics
NPI:1922358753
Name:ROSENTHAL, LAURI (MS)
Entity Type:Individual
Prefix:MS
First Name:LAURI
Middle Name:
Last Name:ROSENTHAL
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 BLACK HORSE RUN
Mailing Address - Street 2:
Mailing Address - City:BELLE MEAD
Mailing Address - State:NJ
Mailing Address - Zip Code:08502-4903
Mailing Address - Country:US
Mailing Address - Phone:908-874-4716
Mailing Address - Fax:908-874-7516
Practice Address - Street 1:30 BROWER LN
Practice Address - Street 2:
Practice Address - City:HILLSBOROUGH
Practice Address - State:NJ
Practice Address - Zip Code:08844-1270
Practice Address - Country:US
Practice Address - Phone:908-256-4861
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-19
Last Update Date:2013-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist
No133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education