Provider Demographics
NPI:1457458473
Name:CANTOR, DOROTHY W (PSYD)
Entity Type:Individual
Prefix:DR
First Name:DOROTHY
Middle Name:W
Last Name:CANTOR
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:526 E BROAD ST
Mailing Address - Street 2:
Mailing Address - City:WESTFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07090-2116
Mailing Address - Country:US
Mailing Address - Phone:908-232-1951
Mailing Address - Fax:908-232-5259
Practice Address - Street 1:526 E BROAD ST
Practice Address - Street 2:
Practice Address - City:WESTFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07090-2116
Practice Address - Country:US
Practice Address - Phone:908-232-1951
Practice Address - Fax:908-232-5259
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ1266103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJCA 607893Medicare ID - Type Unspecified