Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080A0000X | Adolescent Medicine | OS003487L | PA |
NPI | 1255428629 |
---|---|
Provider Name | Dr. James Gordon Kantor |
First Address | Elkins Park, PA 19027-1046 |
Second Address | Elkins Park, PA 19027-1046 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/10/2006 |
Last Update Date | 20/03/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0008441070005 | (05) | PA |