Provider Demographics
NPI:1811966914
Name:ROSENTHAL, ANDREW M (MD)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:M
Last Name:ROSENTHAL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37 KNIGHTS CT
Mailing Address - Street 2:
Mailing Address - City:UPPER SADDLE RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:07458-1643
Mailing Address - Country:US
Mailing Address - Phone:845-565-1989
Mailing Address - Fax:845-863-0072
Practice Address - Street 1:320 ROBINSON AVE
Practice Address - Street 2:C/O ORANGE RADIOLOGY ASSOCIATES, PC
Practice Address - City:NEWBURGH
Practice Address - State:NY
Practice Address - Zip Code:12550-3353
Practice Address - Country:US
Practice Address - Phone:845-565-1989
Practice Address - Fax:845-863-0072
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2008-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1307832085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY300069232OtherRAILROAD MEDICARE
NY300085087OtherRAILROAD MEDICARE
NY300096712OtherRAILROAD MEDICARE
NY300104504OtherRAILROAD MEDICARE
NY200024880OtherRAILROAD MEDICARE
NY00785135Medicaid
NY300104458OtherRAILROAD MEDICARE
NY300104449OtherRAILROAD MEDICARE
NY300104451OtherRAILROAD MEDICARE
NY300107690OtherRAILROAD MEDICARE
NY300092544OtherRAILROAD MEDICARE
NYB78622Medicare UPIN
NY300085087OtherRAILROAD MEDICARE