Provider Demographics
NPI:1467455352
Name:KANE, ROBERT LEE (DC)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:LEE
Last Name:KANE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:DR
Other - First Name:LEE
Other - Middle Name:
Other - Last Name:KANE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:228 TRIANGLE ST
Mailing Address - Street 2:STE 4
Mailing Address - City:AMHERST
Mailing Address - State:MA
Mailing Address - Zip Code:01002-2169
Mailing Address - Country:US
Mailing Address - Phone:413-549-1500
Mailing Address - Fax:413-549-7535
Practice Address - Street 1:228 TRIANGLE ST
Practice Address - Street 2:STE 4
Practice Address - City:AMHERST
Practice Address - State:MA
Practice Address - Zip Code:01002-2169
Practice Address - Country:US
Practice Address - Phone:413-549-1500
Practice Address - Fax:413-549-7535
Is Sole Proprietor?:Yes
Enumeration Date:2005-05-24
Last Update Date:2012-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1272111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA13472OtherHEALTH NEW ENGLAND
MA350139OtherHARVARDPILGRIM HEALTHCARE
MA1611941Medicaid
MA001272OtherTUFTS HEALTH PLAN
MAY36282Medicare ID - Type Unspecified
MA13472OtherHEALTH NEW ENGLAND