Doctor Name: | JEROME CANTOR |
NPI Number: | 1467860148 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | 127276 |
Business Practice Address: | 258 82nd St Brooklyn, NY - 112093811 |
Business Phone Number: | 7182383415 |
Business Fax Number: | |
Mailing Address: | 258 82nd St, BROOKLYN |
State: | NY |
Postal Code: | 112093811 |
Phone Number: | 7182383415 |
Fax Number: | |
NPI Enumeration Date: | 07/25/2014 |
NPI Last Update Date: | 07/25/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 127276 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |