Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | 164 | CT |
Y | 222Z00000X | Podiatrist | 164 | CT |
N | 2081S0010X | Sports Medicine | 164 | CT |
N | 213ES0000X | Sports Medicine | 164 | CT |
N | 213ES0131X | Foot Surgery | 164 | CT |
NPI | 1346241510 |
---|---|
Provider Name | Dr. Allan I. Rosenthal |
First Address | Ridgefield, CT 06877-4514 |
Second Address | Ridgefield, CT 06877-4514 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/08/2005 |
Last Update Date | 10/03/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
010164 | CONNECTICARE (01) | CT |
030000164CT01 | ANTHEM (01) | CT |
041251 | HEALTHNET (01) | CT |
13098 | GHI (01) | NY |
4006334 | (05) | CT |
T22823 | (02) | CT |