Provider Demographics
NPI:1811180789
Name:DR. RICHARD ROSENTHAL AND ASSOCIATES
Entity type:Organization
Organization Name:DR. RICHARD ROSENTHAL AND ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:F
Authorized Official - Last Name:ROSENTHAL
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:614-237-2099
Mailing Address - Street 1:2978 E BROAD ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43209-1965
Mailing Address - Country:US
Mailing Address - Phone:614-237-2099
Mailing Address - Fax:
Practice Address - Street 1:2978 E BROAD ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43209-1965
Practice Address - Country:US
Practice Address - Phone:614-237-2099
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-23
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4309332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000205533OtherANTHEM
OH288609568013OtherMEDICAL MUTUAL
OH2200824OtherUNITED HEALTHCARE
OH288609568013OtherMEDICAL MUTUAL
OH4144910001Medicare NSC
OH=========OtherTAX ID