Provider Demographics
| NPI: | 1316130875 |
|---|---|
| Name: | ROSENTHAL, STEVE (DC, LAC, CA) |
| Entity type: | Individual |
| Prefix: | DR |
| First Name: | STEVE |
| Middle Name: | |
| Last Name: | ROSENTHAL |
| Suffix: | |
| Gender: | M |
| Credentials: | DC, LAC, CA |
| Other - Prefix: | |
| Other - First Name: | |
| Other - Middle Name: | |
| Other - Last Name: | |
| Other - Suffix: | |
| Other - Last Name Type: | |
| Other - Credentials: | |
| Mailing Address - Street 1: | 1005 WASHINGTON BLVD |
| Mailing Address - Street 2: | WASHINGTON WELLNESS CENTER |
| Mailing Address - City: | ROBBINSVILLE |
| Mailing Address - State: | NJ |
| Mailing Address - Zip Code: | 08691-3119 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 609-426-1700 |
| Mailing Address - Fax: | 609-426-0099 |
| Practice Address - Street 1: | 1005 WASHINGTON BLVD |
| Practice Address - Street 2: | WASHINGTON WELLNESS CENTER |
| Practice Address - City: | ROBBINSVILLE |
| Practice Address - State: | NJ |
| Practice Address - Zip Code: | 08691-3119 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 609-426-1700 |
| Practice Address - Fax: | 609-426-0099 |
| Is Sole Proprietor?: | No |
| Enumeration Date: | 2007-08-19 |
| Last Update Date: | 2011-06-15 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Licenses
| State | License ID | Taxonomies |
|---|---|---|
| NY | 002192 | 111N00000X |
| NY | 908 | 171100000X |
| NJ | 275 | 171100000X |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization |
|---|---|---|---|---|
| Yes | 171100000X | Other Service Providers | Acupuncturist | |
| No | 111N00000X | Chiropractic Providers | Chiropractor |
Provider Identifiers
| State | Identifier ID | ID Type | Issuer |
|---|---|---|---|
| NY | C02192-5W | Other | NYS WORKER'S COMP |