1154595866 NPI number — KANTOR AND RASSOW PARTNERSHIP

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1154595866 NPI number — KANTOR AND RASSOW PARTNERSHIP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
KANTOR AND RASSOW PARTNERSHIP
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
CHIROPRACTIC CENTER OF WESTPORT
Provider Other Organization Name Type Code:
5
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1154595866
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/20/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
225 MAIN ST
Provider Second Line Business Mailing Address:
SUITE 204
Provider Business Mailing Address City Name:
WESTPORT
Provider Business Mailing Address State Name:
CT
Provider Business Mailing Address Postal Code:
06880-3216
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
203-226-7722
Provider Business Mailing Address Fax Number:
203-226-1625

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
225 MAIN ST
Provider Second Line Business Practice Location Address:
SUITE 204
Provider Business Practice Location Address City Name:
WESTPORT
Provider Business Practice Location Address State Name:
CT
Provider Business Practice Location Address Postal Code:
06880-3216
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
203-226-7722
Provider Business Practice Location Address Fax Number:
203-226-1625
Provider Enumeration Date:
04/15/2008

Additional Information

Authorized Official

Authorized Official Last Name:
KANTOR
Authorized Official First Name:
JONATHAN
Authorized Official Middle Name:
S
Authorized Official Title or Position:
PARTNER
Authorized Official Telephone Number:
203-226-7722

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  000439 , registered in the state of CT ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: C01671 . This is a "GROUP ID #" identifier . This identifiers is of the category "OTHER".




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