Provider Demographics
NPI:1023750668
Name:KANTER, LORI B (DP M, RD)
Entity type:Individual
Prefix:DR
First Name:LORI
Middle Name:B
Last Name:KANTER
Suffix:
Gender:F
Credentials:DP M, RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 MICHAELS LN
Mailing Address - Street 2:
Mailing Address - City:GLEN HEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11545-2015
Mailing Address - Country:US
Mailing Address - Phone:516-671-8806
Mailing Address - Fax:
Practice Address - Street 1:4 MICHAELS LN
Practice Address - Street 2:
Practice Address - City:GLEN HEAD
Practice Address - State:NY
Practice Address - Zip Code:11545-2015
Practice Address - Country:US
Practice Address - Phone:516-671-9052
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-13
Last Update Date:2022-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN004105-01213E00000X
NY007647-1133NN1002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist