Provider Demographics
NPI:1619062536
Name:KANTER, ERIC
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:
Last Name:KANTER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12760 W NORTH AVE
Mailing Address - Street 2:BUILDING A
Mailing Address - City:BROOKFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53005-4628
Mailing Address - Country:US
Mailing Address - Phone:262-439-5500
Mailing Address - Fax:866-439-5221
Practice Address - Street 1:12760 W NORTH AVE
Practice Address - Street 2:BUILDING A
Practice Address - City:BROOKFIELD
Practice Address - State:WI
Practice Address - Zip Code:53005-4628
Practice Address - Country:US
Practice Address - Phone:262-439-5500
Practice Address - Fax:866-439-5221
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2014-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI451362084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry