Provider Demographics
NPI:1164556429
Name:KANE, JOHN
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:
Last Name:KANE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75-59 263RD STREET
Mailing Address - Street 2:THE ZUCKER HILLSIDE HOSPITAL -DEPT OF PSYCHIATRY
Mailing Address - City:GLEN OAKS
Mailing Address - State:NY
Mailing Address - Zip Code:11004
Mailing Address - Country:US
Mailing Address - Phone:718-470-8141
Mailing Address - Fax:
Practice Address - Street 1:75-59 263RD STREET
Practice Address - Street 2:THE ZUCKER HILLSIDE HOSPITAL -DEPT OF PSYCHIATRY
Practice Address - City:GLEN OAKS
Practice Address - State:NY
Practice Address - Zip Code:11004
Practice Address - Country:US
Practice Address - Phone:718-470-8141
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1140722084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry