1467978569 NPI number — DR. RACHEL MARGARET KANTOR PSYD

Table of content: DR. RACHEL MARGARET KANTOR PSYD (NPI 1467978569)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1467978569 NPI number — DR. RACHEL MARGARET KANTOR PSYD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KANTOR
Provider First Name:
RACHEL
Provider Middle Name:
MARGARET
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PSYD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
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:
1467978569
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/29/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
860 WINTER ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WALTHAM
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02451-1449
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
814-347-2447
Provider Business Mailing Address Fax Number:
781-893-5321

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
860 WINTER ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WALTHAM
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02451-1449
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
781-434-7344
Provider Business Practice Location Address Fax Number:
781-893-5321
Provider Enumeration Date:
08/21/2017

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 103TC0700X , with the licence number:  10912 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2025 www.npivalidator.com