Provider Demographics
NPI:1154595866
Name:KANTOR AND RASSOW PARTNERSHIP
Entity type:Organization
Organization Name:KANTOR AND RASSOW PARTNERSHIP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:S
Authorized Official - Last Name:KANTOR
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:203-226-7722
Mailing Address - Street 1:225 MAIN ST
Mailing Address - Street 2:SUITE 204
Mailing Address - City:WESTPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06880-3216
Mailing Address - Country:US
Mailing Address - Phone:203-226-7722
Mailing Address - Fax:203-226-1625
Practice Address - Street 1:225 MAIN ST
Practice Address - Street 2:SUITE 204
Practice Address - City:WESTPORT
Practice Address - State:CT
Practice Address - Zip Code:06880-3216
Practice Address - Country:US
Practice Address - Phone:203-226-7722
Practice Address - Fax:203-226-1625
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-15
Last Update Date:2012-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000439111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
C01671OtherGROUP ID #
C01671OtherGROUP ID #
350000316Medicare PIN