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General NPI Number Information
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NPI Number | 1316143290
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Entity Type | Individual
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Provider Name | MR. JERRY MARTIN KANTOR
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Gender | Male
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Dates
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Enumeration Date | 06/26/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 332 WASHINGTON ST. VITAL FORCE HEALTH CARE, SUITE 380
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City | WELLESLEY HILLS
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State | MA
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Zip | 02481
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Country | US
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Telephone | 781-431-1221
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Fax | 781-305-2077
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Provider Business Mailing Address
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Address Line | 628 SOUTH ST 2
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City | ROSLINDALE
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State | MA
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Zip | 02131-1716
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Country | US
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Telephone | 617-327-3227
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 143
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 175L00000X
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Taxonomy Name | Homeopath
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License Number |
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License Number State |
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