Provider Demographics
NPI:1396018495
Name:RUTH B. KANTOR, M.D., P.A.
Entity Type:Organization
Organization Name:RUTH B. KANTOR, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RUTH
Authorized Official - Middle Name:B
Authorized Official - Last Name:KANTOR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-467-3267
Mailing Address - Street 1:212 SHORT HILLS AVE
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07081-1040
Mailing Address - Country:US
Mailing Address - Phone:973-467-3267
Mailing Address - Fax:973-564-9070
Practice Address - Street 1:212 SHORT HILLS AVE
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07081-1040
Practice Address - Country:US
Practice Address - Phone:973-467-3267
Practice Address - Fax:973-564-9070
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-21
Last Update Date:2012-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJNJ50467261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)