Provider Demographics
NPI:1366774226
Name:MENDELSON MD PC & ROSENTHAL MD PC
Entity type:Organization
Organization Name:MENDELSON MD PC & ROSENTHAL MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:G
Authorized Official - Last Name:ROSENTHAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:631-331-2121
Mailing Address - Street 1:5360 NESCONSET HWY
Mailing Address - Street 2:
Mailing Address - City:PT JEFF STA
Mailing Address - State:NY
Mailing Address - Zip Code:11776-2018
Mailing Address - Country:US
Mailing Address - Phone:631-331-2121
Mailing Address - Fax:631-331-3694
Practice Address - Street 1:5360 NESCONSET HWY
Practice Address - Street 2:
Practice Address - City:PT. JEFF. STA
Practice Address - State:NY
Practice Address - Zip Code:11776
Practice Address - Country:US
Practice Address - Phone:631-331-2121
Practice Address - Fax:631-331-3694
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-03
Last Update Date:2010-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty