Provider Demographics
NPI:1528030491
Name:KANTOR AND TKATCH ASSOCIATES PC
Entity Type:Organization
Organization Name:KANTOR AND TKATCH ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:EVA
Authorized Official - Middle Name:
Authorized Official - Last Name:KUNZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-564-0564
Mailing Address - Street 1:205 S FRONT ST
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17104-1619
Mailing Address - Country:US
Mailing Address - Phone:717-231-8343
Mailing Address - Fax:717-782-5971
Practice Address - Street 1:205 S FRONT ST
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17104-1619
Practice Address - Country:US
Practice Address - Phone:717-231-8343
Practice Address - Fax:717-782-5971
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-06
Last Update Date:2009-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD017151E207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0006539650004Medicaid
PA072610SRDMedicare PIN
PA0006539650004Medicaid
PAP00100951Medicare PIN
PAE55627Medicare UPIN
PA078957Medicare PIN
PA609745SRDMedicare PIN
PADB3811Medicare PIN
PAP00125425Medicare PIN