Provider Demographics
NPI:1982687570
Name:ROSENTHAL, BRETT S (DO)
Entity Type:Individual
Prefix:DR
First Name:BRETT
Middle Name:S
Last Name:ROSENTHAL
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:301 LIPPINCOTT DR STE 410
Mailing Address - Street 2:
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-4197
Mailing Address - Country:US
Mailing Address - Phone:856-355-0340
Mailing Address - Fax:856-355-0330
Practice Address - Street 1:401 KINGS HWY S
Practice Address - Street 2:BUILDING 5
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08034-2500
Practice Address - Country:US
Practice Address - Phone:856-428-8992
Practice Address - Fax:856-428-9614
Is Sole Proprietor?:No
Enumeration Date:2005-11-28
Last Update Date:2024-02-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MB07215700207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0076643Medicaid
NJP00188514Medicare PIN
NJ0076643Medicaid
I16617Medicare UPIN