Provider Demographics
NPI:1417214966
Name:KANTER PHYSICAL MEDICINE & REHAB PC
Entity Type:Organization
Organization Name:KANTER PHYSICAL MEDICINE & REHAB PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRES
Authorized Official - Prefix:
Authorized Official - First Name:MIRIAM
Authorized Official - Middle Name:E
Authorized Official - Last Name:KANTER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-441-3211
Mailing Address - Street 1:10509 JAMAICA AVE
Mailing Address - Street 2:
Mailing Address - City:RICHMOND HILL
Mailing Address - State:NY
Mailing Address - Zip Code:11418-2014
Mailing Address - Country:US
Mailing Address - Phone:718-441-3211
Mailing Address - Fax:718-441-3744
Practice Address - Street 1:10509 JAMAICA AVE
Practice Address - Street 2:
Practice Address - City:RICHMOND HILL
Practice Address - State:NY
Practice Address - Zip Code:11418-2014
Practice Address - Country:US
Practice Address - Phone:718-441-3211
Practice Address - Fax:718-441-3744
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-20
Last Update Date:2012-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY196026-1OtherSTATE LICENSE