Provider Demographics
NPI:1053422188
Name:ROSENTHAL, DAVID SETH (DC)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:SETH
Last Name:ROSENTHAL
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 300104
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11430-0104
Mailing Address - Country:US
Mailing Address - Phone:516-652-6205
Mailing Address - Fax:
Practice Address - Street 1:139 E 57TH ST
Practice Address - Street 2:9TH FLOOR/PENTHOUSE
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-2102
Practice Address - Country:US
Practice Address - Phone:516-652-6205
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2009-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008816111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03183Medicare PIN