Provider Demographics
NPI:1386177350
Name:CANTEY, LA SHEUNE
Entity type:Individual
Prefix:MS
First Name:LA SHEUNE
Middle Name:
Last Name:CANTEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3315
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:NY
Mailing Address - Zip Code:10553-3315
Mailing Address - Country:US
Mailing Address - Phone:347-560-9661
Mailing Address - Fax:
Practice Address - Street 1:465 E LINCOLN AVE APT 110
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:NY
Practice Address - Zip Code:10552-3539
Practice Address - Country:US
Practice Address - Phone:347-560-9661
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-06
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist