Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111NN1001X | Nutrition | 26290 | CA |
Y | 111NN1001X | Nutrition | X009273 | NY |
NPI | 1457411084 |
---|---|
Provider Name | Dr. Joshua Kantor |
First Address | New York, NY 10016-1723 |
Second Address | New York, NY 10016-1723 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/12/2006 |
Last Update Date | 08/07/2007 |