Provider Demographics
NPI:1760484554
Name:CANTOR, LILIAH (MD)
Entity Type:Individual
Prefix:
First Name:LILIAH
Middle Name:
Last Name:CANTOR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75 KENNARD RD
Mailing Address - Street 2:
Mailing Address - City:MAHOPAC
Mailing Address - State:NY
Mailing Address - Zip Code:10541-4121
Mailing Address - Country:US
Mailing Address - Phone:914-329-0478
Mailing Address - Fax:
Practice Address - Street 1:297 KNOLLWOOD RD STE 333
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10607-1838
Practice Address - Country:US
Practice Address - Phone:914-329-0478
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-11
Last Update Date:2022-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2340092084N0402X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0402XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology with Special Qualifications in Child NeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02658799Medicaid
NY576N1EA202Medicare PIN
NY576N1EA201Medicare PIN