Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | 227604 | NY |
N | 207R00000X | Internist | 227604 | NY |
N | 111NI0900X | Internist | 227604 | NY |
N | 207RA0201X | Internist - Allergy & Immunology | 227604 | NY |
N | 2080P0201X | Pediatric Allergist | 227604 | NY |
NPI | 1174615397 |
---|---|
Provider Name | David W Rosenthal |
First Address | Great Neck, NY 11021-5502 |
Second Address | Great Neck, NY 11021-5310 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/09/2006 |
Last Update Date | 05/08/2008 |