Provider Demographics
NPI:1336212133
Name:ROSENTHAL, CHERYL MAY (PSYD)
Entity type:Individual
Prefix:DR
First Name:CHERYL
Middle Name:MAY
Last Name:ROSENTHAL
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:52 DIMICK ST #3
Mailing Address - Street 2:
Mailing Address - City:SOMERVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:02143-4343
Mailing Address - Country:US
Mailing Address - Phone:617-320-7223
Mailing Address - Fax:
Practice Address - Street 1:20 SACRAMENTO ST
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02138-1856
Practice Address - Country:US
Practice Address - Phone:617-320-7223
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA7577103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical