Provider Demographics
NPI:1427054782
Name:ROSENTHAL, CYNTHIA (DO)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:
Last Name:ROSENTHAL
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 MONTAUK HWY
Mailing Address - Street 2:
Mailing Address - City:WEST ISLIP
Mailing Address - State:NY
Mailing Address - Zip Code:11795-4927
Mailing Address - Country:US
Mailing Address - Phone:631-376-3000
Mailing Address - Fax:631-224-8560
Practice Address - Street 1:1000 MONTAUK HWY
Practice Address - Street 2:
Practice Address - City:WEST ISLIP
Practice Address - State:NY
Practice Address - Zip Code:11795-4927
Practice Address - Country:US
Practice Address - Phone:631-376-3000
Practice Address - Fax:631-224-8560
Is Sole Proprietor?:No
Enumeration Date:2005-06-22
Last Update Date:2008-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1958682080P0203X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0203XAllopathic & Osteopathic PhysiciansPediatricsPediatric Critical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY86952OtherVYTRA HEALTH CARE
NYP1047235OtherOXFORD
NY01806202Medicaid
NY2C2617OtherHEALTHNET
NY76-86062OtherUHC CHILD HEALTH PLUS
NY43N221OtherBLUE CROSS BLUE SHIELD
NY0522690OtherAETNA/US HEALTHCARE
NY4265641OtherCIGNA
NY46386OtherMAGNACARE
NY6101386OtherGHI
NY040426010670OtherFIDELIS
NYAA50732OtherMDNY
NY010195868NY01OtherANTHEM NY