Provider Demographics
NPI:1316132517
Name:JAMES S. ROSENTHAL, MD PC
Entity type:Organization
Organization Name:JAMES S. ROSENTHAL, MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:S
Authorized Official - Last Name:ROSENTHAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:413-736-7900
Mailing Address - Street 1:780 CHESTNUT ST
Mailing Address - Street 2:SUITE 19
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01107-1610
Mailing Address - Country:US
Mailing Address - Phone:413-736-7900
Mailing Address - Fax:413-736-2048
Practice Address - Street 1:780 CHESTNUT ST
Practice Address - Street 2:SUITE 19
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01107-1610
Practice Address - Country:US
Practice Address - Phone:413-736-7900
Practice Address - Fax:413-736-2048
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-11
Last Update Date:2007-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA59174207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3164292Medicaid
MAB74926Medicare UPIN