Individual
LAUREL M ROSENTHAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
15 PLEASANT ST, AU SABLE FORKS, NY 12912-0897
(518) 647-8164
(518) 647-2127
Mailing address
P.O. BOX 277, ELIZABETHTOWN, NY 12932-0277
(518) 873-3002
(518) 873-2005
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
136958
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01770098
—
NY
01
—
080084134
RAILROAD MEDICARE
NY
Enumeration date
08/05/2006
Last updated
07/03/2019
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