Provider Demographics
NPI:1639296866
Name:KANS, ROBERT EMMETT JR (MPT)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:EMMETT
Last Name:KANS
Suffix:JR
Gender:M
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4470 REGENCY PL
Mailing Address - Street 2:SUITE 100
Mailing Address - City:WHITE PLAINS
Mailing Address - State:MD
Mailing Address - Zip Code:20695-3071
Mailing Address - Country:US
Mailing Address - Phone:301-645-6680
Mailing Address - Fax:301-645-5363
Practice Address - Street 1:4470 REGENCY PL
Practice Address - Street 2:SUITE 100
Practice Address - City:WHITE PLAINS
Practice Address - State:MD
Practice Address - Zip Code:20695-3071
Practice Address - Country:US
Practice Address - Phone:301-645-6680
Practice Address - Fax:301-645-5363
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-23
Last Update Date:2014-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD19798225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD611105700OtherDEPT OF LABOR
MD1064250OtherAETNA HMO
MD186COtherCAREFIRST
MD2140256OtherALLIANCE
MD2140256OtherMAMSI
MDK7590001OtherCAREFIRST FOR DC
MD7779123OtherAETNA PPO
MDK7590001OtherBLUE CROSS FEDERAL
MD186COtherCAREFIRST