Provider Demographics
NPI:1578882155
Name:CANTOR, SHIRI PENINIT (MSPT)
Entity Type:Individual
Prefix:
First Name:SHIRI
Middle Name:PENINIT
Last Name:CANTOR
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5282 POST RD
Mailing Address - Street 2:APT 4A
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10471-3072
Mailing Address - Country:US
Mailing Address - Phone:914-419-2113
Mailing Address - Fax:
Practice Address - Street 1:5282 POST RD
Practice Address - Street 2:APT 4A
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10471-3072
Practice Address - Country:US
Practice Address - Phone:914-419-2113
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-22
Last Update Date:2014-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA16619225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist