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NPI Code Detail

MEDICARE: JAY ROBERT CANTOR CSW

MEDICARE: JAY ROBERT CANTOR CSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social WorkerCW013457PA
21041C0700XClinical Social WorkerQ1-0000471DE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1821170630
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAY ROBERT CANTOR CSW
Provider Business Mailing Address
First Line : 503 BRIER AVE
Second Line :
City : WILMINGTON
State : DE
Zip : 19805-1963
Country : US
Telephone Number : 215-518-9197
Fax Number :
Provider Business Practice Location Address
First Line : 590 NAAMANS RD
Second Line :
City : CLAYMONT
State : DE
Zip : 19703-2308
Country : US
Telephone Number : 833-886-2277
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/20/2006
Last Update Date : 11/10/2022

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