Healthcare Provider Details

I. General information

NPI: 1174672430
Provider Name (Legal Business Name): JENNIFER FAITH CANTER M.D., M.P.H.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/09/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 HOSPITAL OVAL W WIHD - CEDARWOOD HALL
VALHALLA NY
10595-1559
US

IV. Provider business mailing address

20 HOSPITAL OVAL W WIHD - CEDARWOOD HALL
VALHALLA NY
10595-1559
US

V. Phone/Fax

Practice location:
  • Phone: 914-493-5333
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number213547
License Number StateNY

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier213547
Identifier TypeOTHER
Identifier StateNY
Identifier IssuerMEDICAL LIC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: