Individual
MIRIAM ROSENTHAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C, LAT, ATC, CPT
Contact information
Practice address
269 UNION ST, LYNN, MA 01901-1314
(781) 581-3900
Mailing address
58 DUNSTER RD UNIT 1, JAMAICA PLAIN, MA 02130-2704
(704) 430-7693
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
36002669A
IN
363A00000X
Physician Assistant
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/21/2015
Last updated
10/13/2023
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