Provider Demographics
NPI:1750689352
Name:CANTOR, MICHAEL ELLIOT (DO)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:ELLIOT
Last Name:CANTOR
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 22239
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10087-0001
Mailing Address - Country:US
Mailing Address - Phone:702-899-0595
Mailing Address - Fax:702-977-1496
Practice Address - Street 1:101 THEALL RD
Practice Address - Street 2:
Practice Address - City:RYE
Practice Address - State:NY
Practice Address - Zip Code:10580-1406
Practice Address - Country:US
Practice Address - Phone:872-231-3162
Practice Address - Fax:702-977-1496
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-05
Last Update Date:2025-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT56506208100000X
CODR0054623208100000X
NJUNKNOWN (RESIDENT)208100000X
NY289128208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY07886515Medicaid