Individual
SUSAN ROSENTHAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
20 CHAPEL ST APT C612, BROOKLINE, MA 02446-7403
(732) 672-0224
Mailing address
20 CHAPEL ST APT C612, BROOKLINE, MA 02446-7403
(732) 672-0224
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
25MA04598100
NJ
2080P0206X
Pediatric Gastroenterology Physician
Primary
MA45981
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0513105
—
NJ
Enumeration date
10/26/2006
Last updated
11/13/2023
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