Provider Demographics
NPI:1609957091
Name:KANTER, NORMAN J (PHD)
Entity Type:Individual
Prefix:
First Name:NORMAN
Middle Name:J
Last Name:KANTER
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:199 EAST MAIN STREET
Mailing Address - Street 2:SUITE 1
Mailing Address - City:SMITHTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:11787-2892
Mailing Address - Country:US
Mailing Address - Phone:631-724-6737
Mailing Address - Fax:631-265-4646
Practice Address - Street 1:199 EAST MAIN STREET
Practice Address - Street 2:SUITE 1
Practice Address - City:SMITHTOWN
Practice Address - State:NY
Practice Address - Zip Code:11787-2892
Practice Address - Country:US
Practice Address - Phone:631-724-6737
Practice Address - Fax:631-265-4646
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0050351103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
0094988OtherVALUEOPTIONS
004341259OtherAETNA
21360DOtherMHN
P32254991OtherGEHA
P704543OtherOXFORD
10927OtherVYTRA
32254991OtherMULTIPLAN
P32254991OtherGEHA