Provider Demographics
NPI:1316993090
Name:KANTHOR, HAROLD A (MD)
Entity type:Individual
Prefix:DR
First Name:HAROLD
Middle Name:A
Last Name:KANTHOR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 EMPIRE BLVD
Mailing Address - Street 2:SUITE 150
Mailing Address - City:WEBSTER
Mailing Address - State:NY
Mailing Address - Zip Code:14580-1957
Mailing Address - Country:US
Mailing Address - Phone:585-787-1250
Mailing Address - Fax:585-787-1253
Practice Address - Street 1:2000 EMPIRE BLVD
Practice Address - Street 2:SUITE 150
Practice Address - City:WEBSTER
Practice Address - State:NY
Practice Address - Zip Code:14580-1957
Practice Address - Country:US
Practice Address - Phone:585-787-1250
Practice Address - Fax:585-787-1253
Is Sole Proprietor?:No
Enumeration Date:2006-05-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY104237208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01285212Medicaid
NY17513VMedicare ID - Type Unspecified
NY01285212Medicaid