Doctor Name: | MRS. JACQUELINE KAY CANTOR |
NPI Number: | 1073531794 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | APRN |
License Number: | 001910 |
Business Practice Address: | 805 Farmington Ave 2nd Fl. West Hartford, CT - 06119 |
Business Phone Number: | 8605080942 |
Business Fax Number: | |
Mailing Address: | 805 Farmington Ave, 2nd Floor WEST HARTFORD |
State: | CT |
Postal Code: | 06119 |
Phone Number: | 8605080942 |
Fax Number: | |
NPI Enumeration Date: | 07/18/2006 |
NPI Last Update Date: | 04/04/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 364SP0808X |
License Number: | 001910 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CT |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Clinical Nurse Specialist |
Taxonomy Specialization: | Psych/Mental Health |
Taxonomy Definition: |