Provider Demographics
NPI:1033451489
Name:CANTOS, IRINA JORDANKA
Entity Type:Individual
Prefix:MS
First Name:IRINA
Middle Name:JORDANKA
Last Name:CANTOS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2735 EASTCHESTER RD FL 2
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10469-5922
Mailing Address - Country:US
Mailing Address - Phone:917-971-0999
Mailing Address - Fax:
Practice Address - Street 1:2735 EASTCHESTER RD FL 2
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10469-5922
Practice Address - Country:US
Practice Address - Phone:917-971-0999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-25
Last Update Date:2013-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist